Chapter 15: Consumer Health & Aging

Every year we get one year older chronologically, does this mean we also get one year older biologically?  Our biological age is the age of our body and this is not dependent on our chronological age.  You can be a 30 year old who is very healthy and has a biological age closer to 20 year old, or you can be a 30 year old who lives an unhealthy lifestyle and has a biological age closer to 40.  Our biological age is highly influenced by the lifestyle choices we make.

In 1900, people lived on average just 47.3 years and by the year 2000, Americans lived an average of 76.8 years.  Life expectancy nearly doubled in just 100 years.  The leading causes of death in 1900 were highly related to infectious disease.  Through numerous public health measures life expectancy has drastically increased and the leading causes of death have transitioned to be more related to a persons lifestyle choices.

The good news is that Americans are living longer lives, but the bad news is that the increase in our older population brings an increase in chronic diseases, such as hypertension, diabetes, arthritis, and dementia.  It is estimated that 80% of older adults have a chronic health condition.  With so many older adults having chronic health conditions we know there will continue to be an increased need for caregivers.  This creates a potential problem because although our older population is growing, or birth rates are declining which may reduce the amount of people to serve as caretakers.

Health Literacy

Chapter one of this book provided a brief introduction to health literacy, this chapter expands on the importance of critically consuming health information  throughout your life and as you age.  The CDC defines personal health literacy as the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.

Finding reliable health information

Millions of consumers get health information from magazines, TV or the Internet. Some of the information is reliable and up to date; some is not. How can you tell the good from the bad to make sure you are making your own health decisions based on the best information?

First, recognize that content on the Internet is unregulated; anyone can publish anything on the Internet. There is sound medical information on the Internet along with dangerous information. You need to be able to tell the difference.

Ask yourself the following:

• Why did the person create the page?
• What’s in it for them?
• Are they trying to sell me something?

The following tips can help you to find current, unbiased information based on research^[1].

• Consider the source–Use recognized authorities
  • Know who is responsible for the content.
  • Look for an “about us” page. Check to see who runs the site: is it a branch of the Federal Government, a non-profit institution, a professional organization, a health system, a commercial organization or an individual.
  • There is a big difference between a site that says, “I developed this site after my heart attack” and one that says, “This page on heart attack was developed by health professionals at the American Heart Association.”
  • Web sites should have a way to contact the organization or webmaster. If the site provides no contact information, or if you can’t easily find out who runs the site, use caution.
• Focus on quality–All Web sites are not created equal
  • Does the site have an editorial board? Is the information reviewed before it is posted?
  • This information is often on the “about us” page, or it may be under the organization’s mission statement, or part of the annual report.
  • See if the board members are experts in the subject of the site. For example, a site on osteoporosis whose medical advisory board is composed of attorneys and accountants is not medically authoritative.
  • Look for a description of the process of selecting or approving information on the site. It is usually in the “about us” section and may be called “editorial policy” or “selection policy” or “review policy.”
  • Sometimes the site will have information “about our writers” or “about our authors” instead of an editorial policy. Review this section to find out who has written the information.
• Be a cyber skeptic–Quackery abounds on the Web
  • Does the site make health claims that seem too good to be true? Does the information use deliberately obscure, “scientific” sounding language? Does it promise quick, dramatic, miraculous results? Is this the only site making these claims?
  • Beware of claims that one remedy will cure a variety of illnesses, that it is a “breakthrough,” or that it relies on a “secret ingredient.”
  • Use caution if the site uses a sensational writing style (lots of exclamation points, for example.)
  • A health Website for consumers should use simple language, not technical jargon.
  • Get a second opinion! Check more than one site.
• Look for the evidence–Rely on medical research, not opinion
  • Does the site identify the author? Does it rely on testimonials?
  • Look for the author of the information, either an individual or an organization. Good examples are “Written by Jane Smith, R.N.,” or “Copyright 2013, American Cancer Society.”
  • If there are case histories or testimonials on the Web site, look for contact information such as an email address or telephone number. If the testimonials are anonymous or hard to track down (“Jane from California”), use caution.
• Check for currency–Look for the latest information
  • Is the information current?
  • Look for dates on documents. A document on coping with the loss of a loved one doesn’t need to be current, but a document on the latest treatment of AIDS needs to be current.
  • Click on a few links on the site. If there are a lot of broken links, the site may not be kept up-to-date.
• Beware of bias–What is the purpose? Who is providing the funding?
  • Who pays for the site?
  • Check to see if the site is supported by public funds, donations or by commercial advertising.
• Advertisements should be labeled. They should say “Advertisement” or “From our Sponsor.”
  • Look at a page on the site, and see if it is clear when content is coming from a non-commercial source and when an advertiser provides it. For example, if a page about treatment of depression recommends one drug by name, see if you can tell if the company that manufactures the drug provides that information. If it does, you should consult other sources to see what they say about the same drug.
• Protect your privacy–Health information should be confidential
  • Does the site have a privacy policy and tell you what information they collect?
  • There should be a link saying “Privacy” or “Privacy Policy.” Read the privacy policy to see if your privacy is really being protected. For example, if the site says “We share information with companies that can provide you with useful products,” then your information isn’t private.
  • If there is a registration form, notice what types of questions you must answer before you can view content. If you must provide personal information (such as name, address, date of birth, gender, mother’s maiden name, credit card number) you should refer to their privacy policy to see what they can do with your information.
• Consult with your health professional–Patient/provider partnerships lead to the best medical decisions.

Health Fraud

When you see statements like “miracle cure,” “revolutionary scientific breakthrough,” or “alternative to drugs or surgery,” what you should be thinking is, “bogus product,”  “Danger,” or “Health fraud alert!”

Health fraud scams have been around for hundreds of years^[2]. The snake oil salesmen of old have morphed into the deceptive, high-tech marketers of today. They prey on people’s desires for easy solutions to difficult health problems, from losing weight to curing serious diseases like cancer. According to the Food and Drug Administration (FDA), a health product is fraudulent if it is deceptively promoted as being effective against a disease or health condition but has not been scientifically proven safe and effective for that purpose.  Health fraud scams can do more than waste your money, they can cause serious injury or even death.

Scammers promote their products through newspapers, magazines, TV infomercials and cyberspace. You can find health fraud scams in retail stores and on countless websites, in popup ads and spam, and on social media sites like Facebook and Twitter.  It is important to understand the signs of fraudulent health product.

The FDA provides the following list of 6 Tip-offs to Rip-offs:

1. One product does it all. Be suspicious of products that claim to cure a wide range of diseases. The agency continues to send warning letters and take enforcement action as appropriate against companies marketing fake cure-all products. These miracle cures don’t exist – they’re bogus – and the only thing these companies are selling is false hope.
2. Personal “success” testimonials. Success stories, such as, “It cured my diabetes” or “It immediately stopped my COVID-19 infection,” are easy to make up and are not a substitute for scientific evidence. Reviews found on popular online marketplaces and social media can be fake.
3. Quick fixes. Few diseases or conditions can be treated quickly, even with legitimate products. Beware of language such as, “Lose 30 pounds in 30 days,” “protects from viral infections,” or “eliminates skin cancer in days.”
4. “All natural” cure or treatment. Don’t be fooled by descriptions like “all-natural cure.” Such phrases are often used in health fraud as an attention-grabber to suggest that a product is safer than conventional treatments. These terms don’t necessarily equate to safety. Some plants found in nature (such as poisonous mushrooms) can be harmful or even kill when consumed. Moreover, the FDA has found numerous products promoted as “all-natural” cures or treatments that contain hidden and dangerously high doses of prescription drug ingredients or other active pharmaceutical ingredients.
5. “Miracle cure.” Alarms should go off when you see this claim or others like it such as, “new discovery,” “guaranteed results,” or “secret ingredient.” If a real cure for a serious disease were FDA-approved, it would be widely reported through the media and prescribed by licensed health professionals—not plastered on advertisements in social media and messaging apps, or buried in websites, print ads, and TV infomercials.
6. Conspiracy theories. Claims like “This is the cure our government or Big Pharma doesn’t want you to know about” are used to distract consumers from the obvious, common-sense questions about the so-called miracle cure.

Healthcare

Healing people has been done differently throughout the world and throughout history.   Many Americans use medical treatments that are not part of mainstream (conventional or western) medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine.

In the U.S., how you pay for your healthcare is dependent on whether you have insurance and the type of insurance you have.  In many other countries healthcare is covered through universal health coverage.

Western medicine: Conventional Medicine

Conventional medicine, also called allopathic medicine, biomedicine, mainstream medicine, orthodox medicine, and Western medicine, is the medical system most Americans are used to.  It is a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery.  Western medicine is the basis of most of the modern healthcare in the world utilizing a systemic approach, incorporating: 1.) physically examining the body and the associated symptoms, 2.) diagnosing diseases and conditions using scientific evidence, and 3.) using treatments that are clinically proven to be effective^[3].

Eastern Medicine: Complementary and Alternative Medicine (CAM)

The words “complementary,” “alternative,” and “integrative,” are often used interchangeably to represent practices that are not included in conventional medicine. These are typically supported by tradition and seldom taught in a Western medical setting.

If a non-mainstream practice is used together with conventional medicine, it’s considered “complementary.” However, If a non-mainstream practice is used in place of conventional medicine, it’s considered “alternative.”  There are many definitions of “integrative” health care, but all involve bringing conventional and complementary approaches together in a coordinated way.  True alternative medicine is uncommon. Most people who use non-mainstream approaches use them along with conventional treatments.

The National Center for Complementary and Integrative Health (NCCIH) is responsible for conducting and supporting research and providing information about complementary health products and practices.

Complementary approaches can be classified by their primary therapeutic input (how the therapy is taken in or delivered), which may be nutritional or psychological/physical.  These include^[4]:

• Mind–body therapies: These combine mental focus, breathing, and body movements to help relax the body and mind.
  • meditation: focused breathing or repetition of words or phrases to quiet the mind and lessen stressful thoughts and feelings.
  • biofeedback: using special machines, the patient learns how to control certain body functions that are normally out of one’s awareness (such as heart rate and blood pressure).
  • hypnosis: a trance-like state in which a person becomes more aware and focused on certain feelings, thoughts, images, sensations or behaviors. A person may feel more calm and open to suggestion in order to aid in healing.
  • yoga: ancient system of practices used to balance the mind and body through stretches and poses, meditation, and controlled breathing
  • tai chi: a form of gentle exercise and meditation that uses slow sets of body movements and controlled breathing
  • imagery: focusing on positive images in the mind, such as imagining scenes, pictures, or experiences to help the body heal
  • creative outlets: interests such as art, music, or dance
• Biologically based practices: This type of CAM uses things found in nature.
  • vitamins: nutrients the body needs in small amounts to function and stay healthy
  • dietary supplements: products added to the diet that may contain ingredients such as vitamins, minerals, and herbs, to name a few
  • botanicals: plants or parts of plants. One type is cannabis.
  • herbs and spices such as turmeric or cinnamon
  • special foods or diets
• Manipulative and body-based practices: These are based on working with one or more parts of the body.
  • massage therapy: a therapy where the soft tissues of the body are kneaded, rubbed, tapped, and stroked
  • chiropractic therapy: a type of manipulation of the spine, joints, and skeletal system
  • reflexology: a type of massage in which pressure is applied to specific points on the feet or hands, which are believed to match up with certain parts of the body
• Energy healing:  Energy healing is based on the belief that a vital energy flows through the body. The goal is to balance the energy flow in the patient. There’s not enough evidence to support the existence of energy fields. However, there are no harmful effects in using these approaches.
  • reiki: placing hands lightly on or just above the person with the goal of guiding energy to help a person’s own healing response
  • therapeutic touch: moving hands over energy fields of the body or gently touching a person’s body

Health insurance in the U.S.

No one plans to get sick or hurt, but most people need medical care at some point.  Health insurance covers essential health benefits critical to maintaining your health and treating illness and accidents, for example getting free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible. Health insurance protects you from unexpected, high medical costs by paying less for covered in-network health care, even before you meet your deductible. People without health coverage are exposed to these costs, which can sometimes lead into extreme debt or even into bankruptcy.

The U.S. does not have universal health coverage, meaning the government does not provide health insurance for every person, rather the U.S. health system is a mix of public and private, for-profit and nonprofit insurers and health care providers^[5]. The federal government provides Medicare, medicaid and the Children’s Health Insurance Program (CHIP).  Private insurance is provided primarily by employers and people can also purchase their own health insurance coverage.  Although there are options for health insurance, there are still about 8.5% of Americans who are un-insured, which is a reduction from 16% in 2010 before the passing of the Patient Protection and Affordable Care Act.

Medicare is health insurance for:

• People 65 or older (eligible to sign up for Medicare 3 months before turning 65)
• Those with a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease) may be able to sign up before 65.

Medicaid is a joint federal and state program that:

• Helps with medical costs for some people with limited income and resources.
• Offers benefits not normally covered by Medicare, like nursing home care and personal care services.

The Children’s Health Insurance Program (CHIP) is a joint federal and state program that:

• provides health coverage to eligible children, through both Medicaid and separate CHIP programs.

Managed Care Plans

• Managed care plans are a type of health insurance. They have contracts with health care providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. How much of your care the plan will pay for depends on the network’s rules.
  • With an Health Maintenance Organizations (HMO) you choose a primary care doctor who coordinates most of your care.  HMO’s usually only pay for care within their specified network of doctors/providers.  HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket.
  • With a Preferred Provider Organizations (PPO) you  tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.
  • Point of Service (POS) plans let you choose between an HMO or a PPO each time you need care.

If you’re unemployed, or your employer does not provide health insurance, you may be able to get an affordable health insurance plan through the Health Insurance Marketplace.  The Health Insurance Marketplace was developed in response to the Patient Protection and Affordable Care Act passed in 2010. Its primary goal is to achieve universal health insurance coverage by facilitating cooperation among employers, citizens, and the government. Its other objectives are to make healthcare more affordable while simultaneously increasing healthcare quality and reducing unnecessary spending^[6].

The Affordable Care Act (ACA) created a dramatically different marketplace for individual health insurance through three key reforms: prohibiting insurers from considering subscribers’ health status or risk; providing substantial subsidies for millions of people to purchase individual coverage, many for the first time in their lives; and creating an “exchange” structure that facilitates comparison shopping.  Due to the ACA the uninsured rate has dropped from 16 percent in 2010 to 8.5%.

Universal Healthcare

The World Health Organization states that:

• Half of the world’s population do not have access to the health care they need.
• 100 million people are driven into poverty each year through out-of-pocket health spending.
• 75% of national health policies strategies and plans are aimed at moving towards universal health coverage.
• Over 930 million people spend at least 10% of their household income on health care.

In an effort to bring healthcare to all people across the world, The World Health Organization (WHO) is encouraging all countries of the world to adopt Universal Health Coverage (UHC).  The WHO is providing support and technical expertise to advance universal health coverage in 115 countries, representing a population of at least 3 billion people.  The goal is to bridge global commitments with country action to achieve universal health coverage.

The WHO defines universal healthcare as “ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user the financial hardship. It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.”

Many countries offer universal healthcare, these include:

• Australia (Healthcare System in Australia)
• Canada (Canadian Health Care System)
• France (French Healthcare System)
• Germany (German Healthcare System – GKV)
• Ireland (Healthcare System in Ireland)
• Italy (Healthcare System in Italy)
• Japan (Japanese Healthcare System)
• New Zealand (New Zealand’s Healthcare System)
• Portugal (Healthcare System in Portugal)
• Spain (Healthcare System in Spain)
• Sweden (Sweden’s Healthcare System)
• United Kingdom (Healthcare System in the UK)

Aging

More than 10,000 people turn 65 every day in the United States, and people are living longer, healthier lives. Healthy lifestyles, planning for retirement, and knowing your options for health care and long-term care are more important than ever before.

Across the world, the number and proportion of people aged 60 years and older in the population is increasing. In 2019, the number of people aged 60 years and older was 1 billion. This number will increase to 1.4 billion by 2030 and 2.1 billion by 2050. This increase is occurring at an unprecedented pace and will accelerate in coming decades, particularly in developing countries.  This historically significant change in the global population requires adaptations to the way societies are structured across all sectors. For example, health and social care, transportation, housing and urban planning. Working to make the world more age-friendly is an essential and urgent part of our changing demographics.

• Between 2015 and 2050, the proportion of the world’s population over 60 years will nearly double from 12% to 22%.
• By 2020, the number of people aged 60 years and older will outnumber children younger than 5 years.
• In 2050, 80% of older people will be living in low- and middle-income countries.
• The pace of population ageing is much faster than in the past.
• All countries face major challenges to ensure that their health and social systems are ready to make the most of this demographic shift.

Adopting healthy habits and behaviors, staying involved in your community, using preventive services, managing health conditions, and understanding all your medications can contribute to a productive and meaningful life.

Cognitive Health

Cognitive health — the ability to clearly think, learn, and remember — is an important component of performing everyday activities. Cognitive health is just one aspect of overall brain health. Brain health refers to how well a person’s brain functions across several areas.

Aspects of brain health include:

• Cognitive health: how well you think, learn, and remember
• Motor function: how well you make and control movements, including balance
• Emotional function: how well you interpret and respond to emotions (both pleasant and unpleasant)
• Tactile function:  how well you feel and respond to sensations of touch — including pressure, pain, and temperature

Alzheimer’s Disease & Related Dementias

Alzheimer’s disease is the most common cause of dementia in older adults. It is a progressive brain disorder that slowly destroys memory and thinking skills. It is not a normal part of aging.  Memory problems are typically one of the first signs of Alzheimer’s disease.  Scientists believe that a combination of genetic, lifestyle, and environmental factors influence when Alzheimer’s disease begins and how it progresses.  Current treatment approaches focus on helping people maintain mental function, manage behavioral symptoms, and slow or delay the symptoms of disease.

Eyes and Vision

As you age, it is normal to notice changes in your vision.

A few common changes for older adults include:

• Losing the ability to see up close
• Having trouble distinguishing colors, such as blue from black
• Needing more time to adjust to changing levels of light

The following eye problems can lead to vision loss and blindness in older adults. They may have few or no early symptoms. Regular eye exams are your best protection.

• Age-related macular degeneration (AMD) can harm the sharp, central vision needed to see objects clearly and to do common things like driving and reading. Your eye care professional will ask about your family history and look for signs of AMD during a dilated eye exam. Treatments are available, and special dietary supplements can help lower your chance of it getting worse.
• Diabetic retinopathy may occur if you have diabetes. It develops slowly, often with no early warning signs. If you have diabetes, be sure to have a dilated eye exam at least once a year. Keeping your blood sugar, blood pressure, and cholesterol under control can prevent diabetic retinopathy or slow its progress in early stages. Laser surgery in later stages can sometimes prevent it from getting worse.
• Cataracts are cloudy areas in the eye’s lens causing blurred or hazy vision. Some cataracts stay small and don’t change your eyesight much. Others become large and reduce vision. Cataract surgery can restore good vision and is a safe and common treatment. If you have a cataract, your eye care professional will watch for changes over time to see if you would benefit from surgery.
• Glaucoma is usually caused by too much fluid pressure inside the eye. If not treated, it can lead to vision loss and blindness. People with glaucoma often have no early symptoms or pain. You can help protect yourself by having dilated eye exams yearly. Glaucoma can be treated with prescription eye drops, lasers, or surgery.
• Dry eye occurs when tear glands don’t work well. You may feel stinging or burning, a sandy feeling as if something is in the eye, or other discomfort. Dry eye is common as people get older, especially for women. Your eye care professional may tell you to use a home humidifier or air purifier, special eye drops (artificial tears), or ointments to treat dry eye. For more severe cases, treatment options might include prescription medication, tear duct plugs, or surgery.

Hearing

Hearing loss is a common problem caused by noise, aging, disease, and heredity. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms. Approximately one in three people between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 has difficulty hearing. But, some people may not want to admit they have trouble hearing.

Some people have a hearing problem and don’t realize it.

You should see your doctor if you:

• Have trouble hearing over the telephone
• Find it hard to follow conversations when two or more people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume so loud that others complain
• Have a problem hearing because of background noise
• Think that others seem to mumble
• Can’t understand when women and children speak to you

Common types of hearing loss include:

• Sudden sensorineural hearing loss, or sudden deafness, is a rapid loss of hearing. It can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. If you or someone you know experiences sudden sensorineural hearing loss, visit a doctor immediately.
• Age-related hearing loss comes on gradually as a person gets older and usually occurs in both ears. It seems to run in families and may occur because of changes in the inner ear and auditory nerve.  The loss is gradual, so someone with presbycusis (age-related hearing loss) may not realize that he or she has lost some of his or her ability to hear.
• Tinnitus is also common in older people. It is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It might be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults.

Healthy Aging

Many factors influence healthy aging. Some of these, such as genetics, are not in our control. Others — like exercise, a healthy diet, going to the doctor regularly, and taking care of our mental health — are within our reach.  Research supported by National Institute on Aging (NIA) and others has identified actions you can take to help manage your health, live as independently as possible, and maintain your quality of life as you age, these include both physical and mental health strategies.

Take care of your physical health:

• Get moving: Exercise and physical activity
  • Physical activity is a cornerstone of healthy aging.
  • As people age, muscle function often declines. Older adults may not have the energy to do everyday activities and can lose their independence. However, exercise can help older adults maintain muscle mass as they age.
  • A study of adults 40 and older found that taking 8,000 steps or more per day, compared to only taking 4,000 steps, was associated with a 51% lower risk of death from all causes^[7].
• Healthy eating: Make smart food choices
  • Making smart food choices can help protect you from certain health problems as you age and may even help improve brain function.
  • A 2021 study analyzing the eating patterns of more than 21,000 participants found that people closely following the Mediterranean-style pattern had a significantly lower risk of sudden cardiac death^[8].
  • A low-salt diet called Dietary Approaches to Stop Hypertension (DASH) has also been shown to deliver significant health benefits
• Getting a good night’s sleep
  • Getting enough sleep helps you stay healthy and alert. Even though older adults need the same seven to nine hours of sleep as all adults, they often don’t get enough.
  • A study, which looked at data from nearly 8,000 people, showed that those in their 50s and 60s who got six hours of sleep or less a night were at a higher risk of developing dementia later in life^[9].
• Quit smoking
  • It doesn’t matter how old you are or how long you’ve been smoking, research confirms that even if you’re 60 or older and have been smoking for decades, quitting will improve your health. Quitting smoking at any age will:
    • Lower your risk of cancer, heart attack, stroke, and lung disease
    • Improve your blood circulation
    • Improve your sense of taste and smell
    • Increase your ability to exercise
    • Set a healthy example for others
• Alcohol and other substances
  • Like all adults, older adults should avoid or limit alcohol consumption. In fact, aging can lead to social and physical changes that make older adults more susceptible to alcohol misuse and abuse and more vulnerable to the consequences of alcohol.
• Go to the doctor regularly
  • Going to the doctor for regular health screenings is essential for healthy aging.
  • A 2021 study found that getting regular check-ups helps doctors catch chronic diseases early and can help patients reduce risk factors for disease, such as high blood pressure and cholesterol levels. People who went to the doctor regularly also reported improved quality of life and feelings of wellness^[10].

Take care of your mental health:

• Social isolation and loneliness
  • As people age, changes such as hearing and vision loss, memory loss, disability, trouble getting around, and the loss of family and friends can make it difficult to maintain social connections. This makes older adults more likely to be socially isolated or to feel lonely.
  • A 2021 study of more than 11,000 adults older than age 70 found that loneliness was associated with a greater risk of heart disease^[11].
• Stress
  • Research shows that constant stress can change the brain, affect memory, and increase the risk of developing Alzheimer’s or related dementias.
  • A meta-analysis funded by the National Institute of Mental Health supports the notion that stress and anxiety rewire the brain in ways that can impact memory, decision-making, and mood^[12].
• Depression and overall mood
  • Although depression is common in older adults, it can be difficult to recognize. For some older adults with depression, sadness is not their main symptom. Instead, they might feel numb or uninterested in activities and may not be as willing to talk about their feelings.
  • A 2020 longitudinal study demonstrated a link between positive mood and better cognitive control^[13].
• Leisure activities and hobbies
  • Your favorite activities are not only fun — they may also be good for your health. Research shows that people who participate in hobbies and social and leisure activities may be at lower risk for some health problems.
  • A study showed that older adults who spent at least an hour reading or engaged in other hobbies had a decreased risk of dementia compared to those who spent less than 30 minutes a day on hobbies^[14].

Dealing with Death

It is a fact that we will one day die, how will you prepare for that day?

Advance Care Planning

Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know—both your family and your health care providers—about your preferences.  These preferences are often put into an advance directive, a legal document that goes into effect only if you are incapacitated and unable to speak for yourself.  An advance directive also allows you to express your values and desires related to end-of-life care.  There are two main elements in an advance directive—a living will and a durable power of attorney for health care.  A living will is a written document that helps you tell doctors how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment.  A durable power of attorney for health care is a legal document naming a health care proxy, someone to make medical decisions for you at times when you are unable to do so.

Organ and Brain Donation

Data shows that 90% of adults support organ donation but only 60% are actually signed up as donors.

Organ donation is the act of taking healthy organs and tissues from one person and giving them to someone else. Making the decision to donate your organs is one of the most generous gifts you can give.  There is no age limit for donation or to sign up. In 2021, one out of every three people who donated organs was over the age of 50. You’re never too old to make a difference — as of 2021, the oldest organ donor in the United States was 92.

While many people think that signing up to be an organ donor includes donating their brain, the purpose and the process of brain donation are different. Rather than helping to keep others alive, such as with kidney donation, brain donation helps advance scientific research. One donated brain can make a huge impact, potentially providing information for hundreds of studies.

Why donate:

• 106,008 men, women, and children are on the national transplant waiting list.
• Every 9 minutes another person is added to the transplant waiting list.
• 17 people die each day waiting for an organ transplant.
• Every donor can save 8 lives and enhance over 75 more.

Retirement and Savings

Retirement requires a lot of planning and consideration. In addition to finances, you need to think about when and where you’ll retire. Experts advise that you may need as much as 80 percent of your pre-retirement income to continue your current standard of living. The exact amount will depend on your individual needs.

As you plan, consider these important questions:

• At what age do you plan to retire?
• Can you participate in an employer’s retirement savings plan? This includes 401(k) plans and traditional pension plans.
• If you have a spouse or partner, will they retire when you do?
• Where do you plan to live when you retire? Will you downsize, rent, or own your home?
• Do you expect to work part-time?
• Will you have the same medical insurance you had while working? Will your insurance coverage change?
• Do you want to travel or pursue a costly, new hobby?
• Will you qualify for social security?

Social Security provides you with a source of income when you retire or if you can’t work due to a disability. It can also support your legal dependents (spouse, children, or parents) with benefits in the event of your death.

While you work, you pay Social Security taxes. This tax money goes into a trust fund that pays benefits to:

• Those who are currently retired
• To people with disabilities
• To the surviving spouses and children of workers who have died

Each year you work, you’ll get credits to help you become eligible for benefits when it’s time for you to retire.