Normal aging takes an inevitable toll—for example, joints and tendons don't work as well as they once did, and your circulatory system weakens. As a result, it's often difficult to separate the normal signs of aging from disease and other problems that can be treated to give you a better quality of life.

Conditions you may be able to improve with proper care…


Fatigue is common among older adults, but the cause often is easy to correct. About 30% of Americans over age 60 have a normal age-related decrease in stomach acid, which is needed to absorb vitamin B-12. However, a B-12 deficiency is not normal and can result in pernicious anemia (marked by defective production of red blood cells).

What to do: If you feel tired and weak, ask your doctor to test you for pernicious anemia, which is correctable with B-12 shots.


Frailty—weight loss, weakness, exhaustion and slowed walking speed—increases your risk for a fall, a leading cause of death among adults over age 65. We all lose muscle mass as we age. but frailty is not normal.

What to do: Test the strength of your thighs. Thigh strength is a predictor of frailty.

To test your thighs: Sit down and fold your arms across your chest. While having someone time you, stand up and sit down five times, as rapidly as possible. If five chair-squats take 14 seconds or more, your thighs are weak. Ask your doctor for advice on thigh-strengthening exercises.

Hearing Loss

One-third of adults over age 65 have presbycusis (age-related (age-related hearing loss). This is normal but can make conversations hard to hear.

What to do: If hearing loss is interfering with your ability to participate in activities or communicate with others, see an audiologist for an exam. Only one in five adults with hear-ing loss that leads to communication problems decides to use a hearing aid—usually because of a fear that the device will be conspicuous or work poorly. However, newer models are small and produce high-quality sound.

High Blood Pressure

Because arteries stiffen with age, a mild in-crease in blood pressure is to be expected as a person grows older. However, high blood pres-sure (above 120/80 mmHg) is not a normal pan of aging.

What to do: Exercise regularly—for exam-ple, walk briskly for 30 minutes at least five times a week. Restrict your salt intake by eat-ing whole foods rather than processed foods. which provide 75% of the typical American's daily salt intake. If these steps fail to lower your blood pressure, talk to your doctor about blood pressure-lowering medication.

Memory Loss

If you forget where you put your car keys, that usually is what doctors call age-related memory loss—and it's a normal part of aging.

But if you forget even briefly what your car keys are for, that's a sign of brain damage (due to a head injury, for example) or a form of dementia, such as Alzheimer's.

Depression, which afflicts nearly one out of every five older adults, often Causes symptoms (such as apathy and lack of concentration) that mimic those of Alzheimer's.

What to do: If Alzheimer's is suspected in you or a loved one, be sure that the doctor has taken a thorough history to detect symptoms of depression, such as suicidal thoughts, weight loss and sleep disturbances.

Sleep Problems

Older adults often suffer sleep problems due to age-related changes in the sleep-wake cycle. However. anyone who is sleeping less than seven hours nightly should attempt to improve his/her sleep.

What to do: Adopt sleep-promoting strategies—for example, reduce the amount of light in the bedroom, get regular exercise and reduce stress. If necessary, sleep medications, such as zolpidem (Ambien) and eszopiclone (Lunesta), can be valuable for short-term relief. If you snore, experience daytime fatigue or suffer morning headaches, ask your doctor if you should be evaluated for sleep apnea, which causes frequent interruptions in breathing during sleep.

Sexual Dysfunction

Older adults have no reason to forgo sexual activity. However, a recent study in The New England Journal of Medicine found that older adults rating their overall health as "poor" or "fair" were 60% to 80% less likely to be sexu-ally active than the rating their health as "very good" or "excellent."

What to do: Get regular physical activity and eat a balanced diet that emphasizes whole foods to help prevent or even reverse diabetes and artery-clogging diseases—conditions that can reduce blood flow to the penis, causing erectile dysfunction. For women, such lifestyle habits promote overall physical fitness, which generally leads to good sexual function.

Tooth Loss

In 1955, half of Americans over age 65 had lost their teeth due to gum disease. Today, a far greater number of Americans over age 65 retain their teeth as a result of improved dental care. Tooth loss is not a normal part of aging.

What to do: Brush twice a day and floss at least once a day. See your dentist twice a year for a cleaning and a checkup.

Urinary Problems

If you're a man and suffer increased urgency or frequency, you may have benign prostatic hyperplasia (BPH), an age-related enlargement of the prostate.

What to do: See your doctor about medication, such as finasteride (Proscar), to help reduce the size of the prostate. Older women often experience stress urinary incontinence—leaking urine while sneezing, laughing or lifting a heavy object. What to do: Kegel exercises—squeezing the pelvic floor muscles that stop or slow the stream of urine—can cure or improve up to 90% of cases. Squeeze the muscles 10 to 20 times a day, holding each contraction for 10 seconds.

Vision Problems

Everyone's eyes change with age. For exam-ple, lenses become stiff, leading to presbyopia (difficulty reading fine print). But loss of vision is not normal—it is almost always a sign of dis-ease, such as age-related macular degeneration.

What to do: After age 50, get an eye exam at least every two years.

Get Your Doctor to Detect Diseases Without Costly Tests

No matter what your age, your doctor should take seriously any condition that would be considered abnormal in a younger person. To do otherwise is "ageist." A careful history and physical exam can diagnose 90% of all diseases without costly medical tests. For a person age 65 or over, a good history takes about an hour.

Problem: Doctors rarely spend that much time with a patient because of reimbursement issues—one 60-minute session pays no more than one 30-minute session.

Solution: Ask your doctor to do a thorough history over two sessions rather than one. The second can usually be billed to insurance as a follow-up visit.

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