Do you find yourself taking stock and setting goals around the time of New Year’s?
It is indeed an excellent time to reflect on the past year. (And wow, quite a lot to reflect on for 2022!)
And although one can set goals at any time of year, the start of the calendar year is a time that seems to inspire many people to think about their health and how to thrive over the coming year.
If better health while aging is important to you, here are my top ten suggestions for the coming year.
If you are in your sixties or older, you can consider these for your own healthy aging. Or, if you are concerned about an older parent’s health, you can help them address these over the coming year.
Just don’t resolve to address them all within the first few weeks of the year. Instead, it’s better to pace yourself, and pick 1-2 items to focus on each month.
10 Ways to Foster Better Health While Aging in 2023
1. Be vaccinated against COVID-19 (including the most recent booster), and take additional precautions when a COVID wave is under way.
I know: a lot of people — including many older adults — in the U.S. think it’s time to get over being careful about COVID.
I disagree! Because when we stop being careful about COVID, it’s older adults who disproportionately bear the consequences.
Now, I’m not advocating for a return to radical isolation measures, forgoing all social gatherings, or wearing masks everywhere forever.
But I believe it’s important that we continue to make an effort in 2023, as individuals and as a society, to reduce COVID transmission and to keep older adults up-to-date on their COVID vaccinations.
It’s true that COVID is less likely to hospitalize or kill a person than it used to be…in part because almost everyone has either had it or been vaccinated (or both).
But COVID remains risky for older adults, especially if they are older and frailer. Every day, hundreds of people are still dying of COVID, of which an estimated 90% of them are aged 65 or older.
Vaccines do make a big difference in reducing COVID risk. But the protective effect wanes more quickly as people get older and frailer. This is why it’s important for older adults to be up-to-date on their COVID booster. (The most recent one available is the fall 2022 bivalent booster.)
And even with a recent booster, anyone can still catch COVID, because the latest variants have evolved to dodge the antibodies that prevent infection. This doesn’t mean the vaccines and boosters don’t work; they definitely protect against severe COVID.
But if you want to avoid getting sick from COVID, or passing it along to someone else, then it’s important to take precautions when COVID rates are high, which they currently are.
I recommend an mRNA vaccine and/or booster for older adults. Moderna has been a more effective vaccine than Pfizer (it’s a higher dose, which is more likely to be effective in aging immune systems), but either is ok.
For my recent updates on COVID vaccines, including a detailed review of how well they work in older adults, the data on boosters, and more, see here: COVID & Aging Adults: 2022 Updates.
And then remember: if you are an older adult, don’t assume that being fully vaccinated and boosted means precautions are no longer needed. A recent booster provides an amazing level of protection, but a minority of older adults (mostly aged 80+) will still experience serious breakthroughs.
So especially when there is a surge going on, you’ll need to continue to wear masks, be cautious about indoor gatherings, and follow public health directives to reduce transmission and exposure.
As a society, we should also invest in cleaner indoor air, better COVID vaccines and treatments, and more.
And will we need to keep getting boosters? Maybe. But it’s a small inconvenience, to help save the lives of hundreds of older adults every day.
2. Make sure you’re doing exercises that challenge leg strength and balance, for fall prevention. Poor leg strength and balance are a common cause of falls in older adults. So working to maintain this is especially important for those older adults who have either fallen over the past year, or feel afraid of falling.
Check on your strength and balance with these easy assessment tests: the Timed Up and Go, the Chair Rise, and the Four Stage Balance Test.
It’s best to do these with a professional, but you can also try them at home first, especially if another person is there to lend a hand.
If you seem low on strength or have poor balance, talk to your doctor or therapist about whether the Otago fall prevention exercises might be right for you. Another form of exercise proven to reduce falls is Tai Chi.
You can view videos showing the assessment exercises and the Otago exercises here.
You can also learn more about which forms of exercise are best maintaining mobility in this podcast episode, featuring geriatric physical therapist Tiffany Shubert: 052 – Maintaining Mobility & Preventing Falls in Aging: Myths & Truths.
3. Walk more. Walking can be an easy way for older adults to stay active. It’s also a form of exercise that can be easily combined with socializing: you can walk with a friend, or walk to visit a friend or other parts of your neighborhood.
Try using a step-tracker to find out how much you walk every day. You can use a low-tech pedometer, an activity bracelet such as a Fitbit, or a smartphone app.
Once you’ve figured out your average daily step count, make a plan to increase your walking by at least a little bit. A research study found that walking at least 6,000 steps/day was associated with less arthritis.
Optional: You can benefit even more from exercise by making sure you regularly engage in the four types of exercise recommended for older adults: strength, endurance, balance, and flexibility. Learn more about the four types of exercise older adults need.
4. Protect your brain — and your balance — by avoiding medications known to dampen brain function. Proper attention to medications is one of the top three actions recommended by National Academies of Medicine, to protect cognitive health while aging.
(For more on how cognition changes with aging, see: 6 Ways that Memory & Thinking Change with Normal Aging & What to Do About This.)
That’s because research has linked such medications to worse cognitive function, and sometimes to the acceleration of cognitive decline.
Plus, most medications that are bad for the brain are also bad for balance. So there is a double benefit in spotting and minimizing these drugs.
And medications that affect the brain are more common than you might think: did you know that diphenhydramine (brand name Benadryl) slows brain function and might be associated with Alzheimer’s?
That’s because Benadryl, like MANY commonly used drugs, is quite anticholinergic. These medications really should come with a memory warning for older adults! But since they don’t, I’ve written about them here, or you can watch the video below to learn to spot the ones older adults use the most often.
For more proven strategies on maintaining brain health, see How to Promote Brain Health.
5. Deprescribe if possible! Review all medications and identify those that may be potentially inappropriate or unnecessary. According to the CDC, every year 177,000 older adults visit the emergency room due to medication problems. Research has also found that “inappropriate prescribing” of drugs is very common.
Although geriatricians especially worry about medications that affect the brain and balance, older adults are also often harmed by blood-thinners, medication for blood pressure, insulin and other medications that lower blood sugar, and non-steroidal anti-inflammatory painkillers (e.g. ibuprofen and naproxen).
To avoid excess risk or harm from medications, it’s best to periodically review the purpose and dosing of all medications. You will need to work with a doctor or pharmacist to do this, but it’s good to do a little homework beforehand. This helps ensure that nothing important falls through the cracks, and will help you better understand the treatment of your health conditions.
Learn a five-step process you can use here: How to Review Medications for Safety & Appropriateness in Aging.
You can also learn more about the most important medications to consider deprescribing here: Deprescribing: How to Be on Less Medication for Healthier Aging.
6. Start — or update — your personal health record. A personal health record is a way for you to keep your own copies of your own essential health information. This can be done with a paper file folder at home, or by keeping digital copies on your computer, or even by using a special service.
All your health information — which often comes from various doctors and clinics — should be kept in a single location that you control. (So accessing your records via your clinic’s patient portal is not the same thing as maintaining a personal health record.)
Personal health records can make it much easier for an older adult to quickly get the right care in the event of an emergency, a second opinion, or a change in doctors.
At a minimum, aim to get copies of all lab results and radiology results from the past two years.
For more on how to set up and maintain a personal health record, see this article: How to Use a Personal Health Record to Improve an Older Person’s Healthcare.
7. If you are on medication for high blood pressure, get a home blood pressure monitor and check your home blood pressure at least once a month.
High blood pressure is one of the most common conditions among older adults, but it’s surprisingly easy for it to be either over-treated (which can lead to falls) or under-treated (which can lead to strokes and heart problems).
Experts have long recommended that patients and doctors use home-based blood pressure measurements to guide care, because these are often more accurate than office-based measurements.
So if you haven’t already gotten in the habit of using a home blood pressure monitor, do it this year!
You can learn more about what to do here: 6 Steps to Better High Blood Pressure Treatment for Older Adults.
8. Address or review your advance planning for health care. Advance care planning is a process of planning ahead, to ensure you get the right medical care in the event of a serious medical problem or life-threatening illness.
Since serious illnesses often leave people at least temporarily unable to tell doctors what they want, it’s important for everyone to have designated a durable power of attorney for healthcare. This is a person whom you’d trust to make medical decisions on your behalf.
A 2013 survey found that only 40.6% of adults over age 50 had completed an advance directive (sometimes called a “living will”). So this is an issue that most people need to address.
Furthermore, since people’s preferences for medical care often change as their health and abilities evolve, it’s essential to regularly review one’s advance care planning documents. It can be dangerous to rely on directives that were completed years ago, because they may no longer be a good fit for one’s current circumstances.
To help you address and review advance planning for healthcare, I highly recommend the PrepareForYourCare.org website. I’m especially a fan of their easy-to-use Advance Directives (I give them to all my patients!), which are available for almost all 50 states here.
I spell out a five-step process you can use here: Advance Planning for Healthcare.
9. Address or review your advance planning for finances. If you were injured or sick and couldn’t manage your finances, who would do this on your behalf?
Many people assume a spouse or family member would be able to take over, but this is often not possible without a durable power of attorney covering finances. (This leaves families stuck with having to request guardianship through the court system.)
Furthermore, many older adults eventually experience age-associated declines in financial abilities, which can make them vulnerable to financial losses or even exploitation by others.
Experts have estimated that every year, older adults lose 3-30 billion dollars due to exploitation and financial abuse.
For more on recognizing (and preventing!) financial exploitation, see Financial Exploitation in Aging: What to Know & What to Do.
Advance planning and simplifying one’s finances can help protect from late-life financial losses. For more on what to do, see Advance Planning for Legal and Financial Matters.
Enough about dutifully checking one’s health & planning ahead! Here are the fun suggestions:
10. Socialize (safely!), contribute, and nourish your soul.
Research has confirmed what many already knew: relationships and contributing to the world are key to maintaining well-being while aging.
Obviously, this has become much more challenging during the coronavirus pandemic! But it still should be possible to remain connected, especially if one takes advantage of outdoor spaces or technology to connect remotely.
And, even the humble telephone can be a powerful tool for keeping in touch.
It’s also important to keep engaging in those activities that feel nourishing to one’s soul. Sometimes these involve other people, but they might also be things you do just for your own engagement and pleasure.
So this year, be sure to take stock of how much time you spend with others. If you realize you often feel isolated or lonely, find ways to connect more with others. You can also consider calling the Friendship Line, a special non-profit service dedicated to supporting lonely older adults.
It’s also good to consider ways to contribute. Volunteering can be an excellent way to connect while bringing purpose to one’s life, but sometimes part-time work or leadership engagements are an option too. Encore.org is a wonderful organization helping people 50+ find “encore roles.”
And then take some time to think what activities bring you contentment and well-being. If you aren’t doing such activities at least a few times a week, ask yourself why. And then see what can be done about the whys.
Bonus idea: Brainstorm a life wishlist. Then go and do at least one thing on the list.
I was really touched a few years ago by the story of “Miss Norma,” who at age 90 left her long-time home to spend a year road-tripping with family.
Her story spoke to me of how it’s almost never too late to do something you’ve always wanted to do, or wished you could do.
In a similar vein, in 2019 and 2020 we’ve had the story of Grandma Joy, who traveled the National Parks with her grandson.
So this year, I hope you’ll make a list of things you still want to do in your life. It could be a special trip, perhaps planned for a time of year when eating and socializing can happen outside. Even if COVID is around, there might be an opportunity for a reconciliation with a family member, taking up a new hobby, or doing something else you’ve thought you’d love to do “someday.”
Write these down. Talk to family or friends about them.
And then make sure to do at least one.
Best wishes for the coming year!
This post was first published in December 2016 and was updated in December of 2022.
I really appreciate your articles, as evidence based, reliable and practical information. I first subscribed when I was caring for my mother. Now it’s for my 73 yo husband with type 2 diabetes.
I particularly appreciated the article “6 Ways that Memory and Thinking Change with Normal Aging”. It was extremely reassuring especially as he refuses to see a geriatritian!
Nicole Didyk, MD says
Merran, thank you for taking the time to leave your comments. It means so much to know that the articles are helpful.
It’s especially satisfying when a reader can get some reassurance and anxiety relief by learning more about aging!
Please keep reading and if you like learning about aging and health in video format, check out my YouTube channel: https://www.youtube.com/channel/UCh9UfvyM79rV4Zip_Sj8PSw
I had my new Pfizer booster in September. I got COVID (#2) in November. It seems clear that the dominant strain was now BQ.1.1 and not part of the booster. So I had really little protection, if any. I did take Paxlovid and in a day or two began feeling better. Overall like a moderate head cold, lighter than COVID #1 (during last January’s surge which was like a moderate head cold with huge fatigue and lingering tiredness for months after). Restarting the quick home testing on day 4 or 5, I was negative which continued until out of quarantine (retirement community requiring 11 days isolation within the community, you can leave to see doctor, etc). I had no side effects from the Paxlovid, although I know someone who was very ill from it.
Besides being one of the careful ones, I thought, I just got flu A in December, morphing into bronchitis. Worse than COVID, mostly due to night constant clearing throat and longer temp at 101.5. Tamiflu caused severe diarrhea that really cleaned me out on the second day, stopped it and the GI problems stopped. Antibiotic on day 9 still causing light nausea and once that is over I expect to feel more upbeat. But doctor says it’ll takes weeks for bronchitis damage to heal and cough stop. Oddly, key symptom for flu was the constant phleghm and coughing at the larynx, soreness – that became bronchitis. Other than the fever and tiredness, I had on day 2 only some light muscle tenseness in arms and chest for under an hour. Day maybe 10 I had this huge wave of nausea, but once I sat down that went away and I did not throw-up. Then it was over. So maybe vaccination helped keep the actual traditional flu symptoms light. The bronchitis is the real kicker. Ugh. Worse than COVID which stayed above the shoulders with very short, light fever.
Well, in addition to the above. A new variant means I can easily catch COVID again! I read today 1/1/2023 that the CDC projected Friday that about 40% of confirmed U.S. Covid cases are caused by the XBB.1.5 strain, up from 20% a week ago. In the Northeast, about 75% of confirmed cases are reported to be XBB.1.5. ” https://www.nbcnews.com/health/health-news/xbb15-subvariant-cdc-reports-new-omicron-strain-taking-rcna63512
And this quote in the news: “Andrew Pekosz, a virologist at Johns Hopkins University, said XBB.1.5 appears to be highly immune evasive because it has an additional mutation that makes it bind better to cells. The virus needs to bind tightly to cells to be more efficient at getting in and that could help the virus be a little bit more efficient at infecting people,” Pekosz told CNBC.”
And the last booster did not have XBB.1.5 like it did not have BQ.1.1.
Leslie Kernisan, MD MPH says
Sorry you’ve had these illnesses! As I’ve been saying in my COVID updates for a while: boosters are important but they generally only provide partial protection against catching COVID. The main benefit of boosters is that they reduce the chance of being hospitalized or otherwise having “severe” COVID, especially for older adults.
So when COVID case counts are high, as they are now: it’s important to take precautions to avoid breathing in COVID from others. Those include N95 masking when indoors, avoiding indoor dining, being very careful about indoor gatherings, and using ventilation and filtration to keep indoor air cleaner.
We don’t have to do these things forever, but it’s a good idea during winter waves.
And yes, the new XBB1.5 variant means we might see more re-infections.
Take care and stay safe!
Is duloxedine a safe drug for nerve pain in elderly people? My 90 year old mom has nerve pain in her leg and also mobility/balance problems due to arthritis. Her doctor is suggesting duloxedine instead of gabapentin.
Nicole Didyk, MD says
Duloxetine is also called Cymbalta, and is classified as an antidepressant. It increases levels of the brain chemicals serotonin and norepinephrine, and helps with low mood but also with nerve-related pain, like that often experienced by those with diabetes or other kinds of peripheral neuropathy. Gabapentin is an antiepileptic and it’s used for nerve pain too.
Older adults can take duloxetine, and I’ve prescribed it many times. If the older adult has impaired kidney function, the dose may need to be reduced, and if kidney function is severely impaired, then duloxetine may not be the best drug for them. Also, it’s vital to know that any antidepressant can increase the risk for falls in an older adult.
Like any medication, it’s best to consider the risks and benefits, and make an individualized choice about what’s best for you.
Chuck Young says
I have been following for several months. This is one of the better newsletters.
Thank you Dr. Kernisan. Every point is well taken.
Nicole Didyk, MD says
Thanks for the kind comment! It is very much appreciated and I hope you’ll continue reading.
Paul R. Graves says
I was hoping one of the top 10 suggestions had BREATHING included in them. I’ve been fascinated with the new book “Breath” by James Nestor. How does proper breathing contribute to better health in older adults? A big topic, I know
Nicole Didyk, MD says
Thanks for the suggestion and the book recommendation! You are correct that breathing practice has been suggested by many as a way to relieve stress and manage health. We’ll think about it for a future article.