Editor’s note: This story was originally published in April 2021.
As we get older, our bodies and minds change — and with that change, our health needs evolve as well.
Things that came without much effort in our 20s are a greater challenge in our 50s. Likewise our health providers may recommend certain medical tests or screenings as we hit certain ages. At the same time, screenings that had become routine may no longer be needed.
“There are physiological changes that occur in our bodies as we get older,” said Dr. Sara Crane, a provider at Northern Lights Primary Care in Hampden. “Our bodies experience the normal wear and tear of aging [and] we find ourselves older and wiser but a bit more worn.”
Paying attention to what our bodies are telling us is one way to age with the best health possible, according to Crane.
“Having a good picture of what’s going on with your body is crucial,” Crane said. “Visiting your primary care giver once a year can help you see where you are doing well and where you may need help.”
The 20s
For a lot of us, our 20s is when we strike out on our own. No longer under our parents’ roof — or watchful eyes — it’s also the first time we are responsible for our own medical care. A 20-year-old body is pretty resilient, but Crane said there are things to consider. In your 20s it’s important to look at your lifestyle and behaviors realistically and how they can impact your health.
“People in their 20s tend to engage in risky behaviors,” Crane said. “There can be issues with inexperienced or aggressive driving, dangerous alcohol use, experimenting with drugs and high risk sexual behaviors.”
People in their 20s who are sexually active should discuss contraception methods with their healthcare provider and use them. They should also take precautions against sexually transmitted diseases — STDs — by using condoms, internal condoms or dental dams to prevent the exchange of bodily fluids. And it’s a good idea to be screened for STDs on a regular basis.
It’s never too early to start paying attention to your body’s vital statistics either. Health screenings in your 20s will give a baseline for your blood pressure, cholesterol and weight. For women, cervical cancer screenings should start at age 21 and be repeated every three years until age 30. If you start building good diet and exercise habits in your 20s, those will help you maintain a level of fitness as you age. Crane said people in their 20s should plan on engaging in moderate intensity activity at least two hours or an hour and a half of vigorous intensity activity a week.
The 30s
Things like sexual health, contraception, diet, weight, blood pressure, cholesterol and exercise remain important in the 30s. But things are starting to change in our bodies. The biggest is our metabolisms are slowing down a bit, so it can be a bit more difficult to work off those extra pounds. For some, desk jobs and a more sedentary lifestyle may result in less moving about. Likewise, work or family commitments may be starting to take up time, so now you may have to pay more attention to carving out time to exercise.
“Primary care in your 30s is still about prevention and wellness,” Crane said. “We like to look at diet and exercise as part of a plan to keep people healthy.
For women in their 30s, the cervical cancer screenings move to once every five years, Crane said.
The 40s
In our 40s it may seem as if human biology is conspiring against us. Things like hormones and the ever slowing of metabolisms makes it more of a challenge to maintain lean muscle mass and not gain weight in body fat. In our 40s is when we start seeing elevated risks for cardiovascular disease, diabetes and elevated levels of cholesterol. Screenings for all three should be done per your health care provider’s recommendations.
Women in their 40s should start regular breast cancer screenings that will continue until around 75.
“Breast cancer is pretty common and it is not unusual to [diagnose] it in your 40s,” Crane said. “Screening early and screening often is often your best chance of survival.”
According to the American Cancer Society, one in eight women will develop a form of breast cancer in their lifetime. How often you are screened depends on your family history and your comfort level with the procedure — a mammogram that some women find uncomfortable or even painful. Your health care provider can help you create your “percentage of risk” based on your own risk factors and family history. This can be used to determine the frequency of breast cancer screenings.
To keep fit in the 40s, cardiovascular exercises are crucial. For women it’s also the time to really hit weight-bearing exercise to build bone mass that can help prevent osteoporosis — brittle bone disease — down the road.
The 50s
Welcome to midlife — but it’s not a crisis by any means. It is, however, the time for women when major hormonal changes can usher in new health concerns with the onset of menopause. You know you have hit menopause when you have not menstruated for 12 months. You may experience symptoms like hot flashes, vaginal dryness, vaginal atrophy and sleep disruption, all of which can create anxiety or depression. Menopause is perfectly natural and you can talk to your health care provider about different strategies or medications to manage the symptoms. It’s also a good time for women to start taking calcium supplements and Vitamin D to further prevent osteoporosis.
For men, the 50s is when you start prostate cancer screenings. When to start the screenings and how often to have them is based heavily on family history and the individual. Generally speaking, you should be screened every three years.
Men and women should have their first colonoscopy at 50 to screen for colon cancer. From there, regular colon screenings should happen every 10 years until age 75. Newer non-invasive colon cancer screenings are also available. Fecal samples are simply sent into a lab for testing, Crane said.
“These at-home tests mean you no longer have to take off a day of work for the colonoscopy prep and a second day for the procedure,” Crane said. “Plus, with so many people not wanting to go to hospitals to get screenings due to COVID concerns, this home test is a godsend.”
However, she points out if the at-home test indicates any irregularities in the colon, you then will need to schedule a full colonoscopy.
Your 50s are no time to cut back on your activity level, Crane said. It’s important for your heart, weight, bone density and wellness to keep on doing those cardio and weight-bearing workouts.
Smokers should start having lung cancer screenings at 55 and continue to have them annually. Crane urges anyone who smokes to quit. Not only will you see improvements to your overall health, but after 15 smoke-free years those annual lung cancer screenings can stop.
The 60s
All those screenings and health considerations of the past five decades are still important, but now you may need to start paying a bit more attention to your surroundings, according to Crane. In their 60s, people start to have greater risks associated with losing their balance and falling.
“The focus in the 60s starts to shift to safety,” Crane said. “You want to start really paying attention to your hearing, vision and balance.”
This is the decade when new health screenings enter in. Women in their 60s should be actively screened for osteoporosis and anyone with a history of smoking should have abnormal aortic aneurysm screens.
It’s in your 60s that you may for the first time hear the word “geriatric” used in connection to your own health care. But geriatric does not mean you need to stop being active. On the contrary, for those who have led an active lifestyle, the 60s can be when you start having more time for those activities as you near retirement age. But you may need to modify those activities to reduce the risk of injury.
The 70s
As you continue to age, your health and medical choices are going to shift a bit from preventive to maintenance. It’s at this point the average life expectancy comes into play — 78.7 years, according to the United States Centers for Disease Control and Prevention. In your 70s, detection of certain diseases or conditions would require treatments that not only don’t extend life beyond the normal expectancy, but also greatly reduce the quality of that life. So things like breast cancer screenings and colon cancer screenings can stop at 75. However, since every person is different, the decision to stop screenings, or to not treat something detected during an exam or screen should be discussed with your care provider.
“Focus on home safety becomes important in your 70s to avoid falls and injuries,” Crane said. “When you get into your 70s, that’s when you start having memory screening tests, too.”
Keep on being as physically active as you are able, but shift your focus away from cardio to stretching exercises since in the 70s you are really going to notice the loss of flexibility and range of motion.
The 80s and beyond
It’s time to have a discussion with your care provider on your overall health and reevaluate your own life expectancy. You may decide that, after decades of tests, screenings and exams, you can stop having many of them because the treatments for whatever a specific test reveals will do nothing to add to the length or quality of your life. A shift to new medications or treatments to manage any health issues might be in order.
It’s also the time to take a frank look at the level of independence you can maintain. Things like the ability to make sound financial decisions, mobility and possible isolation may mean it’s time to consider assisted or group living arrangements.
“I have seen people as they age and are in their 60s but feel more like they are in their 70s,” Crane said. “Then I see the people who are in their 70s or even 80s who are extremely physically fit and are still out there mountain biking and skiing. It’s your body — pay attention to it.”
Maintaining your best health over the years means paying attention to the big picture of aging, Crane said. But it also means paying attention to your own body and not being afraid to ask questions.
