Many of us have favorite songs that can help us relax after a hectic day or get us moving on the dance floor. Music can also be a powerful gateway to memory; for example, a song from our past may bring back memories that trigger strong emotions.

But what is happening in our brains when we hear a song that is meaningful to us? Could music make older adults not only feel better but also improve their health? Much more research is needed before any definitive conclusions can be drawn, but there is growing scientific interest in music’s effects on the brain and body as we age.

How the brain is wired for music and memory

Psyche Loui, Ph.D., leads the Music, Imaging, and Neural Dynamics (MIND) Lab at Northeastern University in Boston. She also plays the violin in Boston’s Longwood Symphony Orchestra and in a variety of local pop and chamber music groups. In the laboratory, she seeks to understand how the parts of the brain that relate to musical perception and processing interact with brain regions controlling learning, memory, and emotions. Interested in music and science most of her life, she first became curious about how music might help people with dementia while volunteering at a nursing home as a high school student.

After little response from residents with advanced dementia to the Beethoven pieces she played on the piano, staff members encouraged her to try something a bit livelier from a book of traditional folk songs. “I just played some old familiar ditties and tunes, and then, amazingly, some of the residents knew all the words and started singing along in close harmony,” said Loui. “That just really struck me.”

Our brains are hard-wired to predict and anticipate familiar rhythms and melodies, Loui explained. It starts with the auditory cortex, the brain region that receives and processes sounds, including voices and music. “When we hear something that we enjoy, that engages not only the auditory cortex, but also the brain’s reward systems that are driven by the neurotransmitter dopamine, which motivates us to seek out and learn new information.”

Another key part of the brain’s dopamine-based reward system is the medial prefrontal cortex, which also processes memories about ourselves. “If I’m listening to music that I’ve enjoyed throughout my life, and that I find familiar, then the auditory system is active, but it’s also communicating and connecting with the medial prefrontal cortex,” said Loui.

Working with like-minded researchers in the Boston area at the Berklee College of Music and Harvard Medical School, Loui and colleagues developed an eight-week mindful music-based listening program for healthy older adults. Participants showed stronger increases in functional connectivity between the auditory system and the medial prefrontal cortex — areas that generally become less active with age — compared to control groups. Their team is now testing out this intervention in older adults with memory impairments, hoping that music can help revive learning and memory functions through this connectivity.

Loui’s latest project is the Multimodal Musical Stimulation for Healthy Neurocognitive Aging study, which is designing and testing a device that pairs music selected by participants with rhythmic, colored LED light patterns. Supported with NIA small business funding, the technology is based on mouse studies in which Alzheimer’s disease-related brain deposits of tau and beta-amyloid proteins were reduced through light and sound stimuli. Loui and colleagues are working on prototypes to test the light and sound intervention as a potential therapy for older adults and for people living with mild cognitive impairment or dementia.

Singing to build cognitive and social connections

Another interesting area of research is the exploration of whether music can strengthen connections not just between our neurons, but also between people, to enhance social networks and reduce isolation and loneliness among older adults.

Can music reduce patient delirium in the ICU?

Between 70% and 80% of intensive care unit (ICU) patients who receive respiratory support from mechanical ventilators experience delirium — a syndrome of sudden, acute confusion that can occur after major surgery or during a serious illness. In some patients, delirium can cause agitation, aggression, or hallucinations while others may be drowsy. Patients who experience delirium tend to have longer stays in the ICU, and more than 30% of patients who develop it experience long-term cognitive impairment. They are also more likely to be transferred to nursing homes or rehabilitation facilities after they leave the hospital.

Soothing sleep with music in people living with dementia

People living with Alzheimer’s or a related dementia often experience sleep disturbances, such as insomnia or waking up during the night. These sleep problems can also disrupt their caregivers’ sleep, contributing to poorer physical and mental health in people who may already feel overwhelmed. For those living with dementia, sleep disruption has been associated with more time in health care facilities, poorer cognitive function, and faster disease progression.

Testing music to reduce agitation and aggression

Other investigators are testing whether music can ease daytime dementia-related issues such as agitation, anxiety, and aggression, all of which can be troubling for people with dementia and their caregivers. The METRIcAL – Music and MEmory: A Pragmatic TRIal for Nursing Home Residents with ALzheimer’s Disease project, led by Vincent Mor, Ph.D., and his colleague Ellen McCreedy, Ph.D., MPH, with the Brown University School of Public Health, explored whether customized playlists of preferred music could reduce disruptive or disturbing behaviors like pacing, calling out verbally, sundowning, or other common dementia symptoms, and lessen reliance on antipsychotic drugs.

The METRIcAL study was conducted in a real-world setting, with almost 1,000 residents with dementia in 54 nursing centers in 10 states. While the study did not find that personalized music was significantly effective in reducing agitated behaviors or psychotropic drug use, there were many lessons learned that could help inform the design of future trials.

Working in harmony: How can we use what we know?

NIA continues to fund research to investigate the potential of music as a therapy. In the meantime, Petrovsky encourages families and caregivers to pay attention to how a person they are caring for responds when music is playing, and which songs they seem to connect with the most.

Evidence on the effectiveness of music on medical conditions continues to be collected. In the meantime, older adults who enjoy music can consider if they want to include it as part of their future care preferences.

To learn more, please visit https://www.nia.nih.gov/news/could-musical-medicine-influence-healthy-aging.

Many people live far away from their family or friends who need help. If you don’t live nearby, you can still provide support and assistance as a long-distance caregiver. This article provides information and resources if you find yourself in a long-distance caregiving role.

What tasks can a long-distance caregiver help with?

Long-distance caregivers take on different roles. From a distance, you may be able to:

• Assist with finances, money management, insurance claims, or paying bills
• Arrange for care management or in-home care by hiring formal caregivers such as home health aides
• Order medical equipment, medicines, and other supplies the person needs
• Serve as an information coordinator by researching information about relevant health conditions and medicines, navigating changing needs, and overseeing insurance benefits
• Help with advance care planning, such as choosing a health care proxy and preparing a living will
• Help find, organize, and update important paperwork and records
• Research long-term care options, such as an assisted living facility or nursing home

You will probably be coordinating these tasks with family, friends, or other caregivers who live nearby. Read more about sharing caregiving responsibilities with family members.

Staying connected from far away

When you don’t live close by, it may take more effort to find out what’s going on and stay up to date with an older person’s needs. Here are some strategies and technologies that long-distance caregivers can use to stay connected:

• Create a list of important phone numbers and email addresses. Keep it in a shared document or spreadsheet online and update it regularly.
• Set up a shared calendar online or in a smartphone app to coordinate with other caregivers.
• With permission, attend the person’s telehealth visits. Telehealth visits are remote appointments with health care providers often done with videoconferencing.
• Participate remotely in conference calls or video meetings with the assisted living facility team or nursing home staff.
• Help the older person learn about the features of their mobile or smart phone, such as texting and video calls.
• If the older person is comfortable using a computer or tablet, set up an email account for them and teach them how to stay safe online.

Making the most of a short visit with an aging parent or relative

Talk to the person ahead of time and find out what they would like to do during your visit. Also check with the primary caregiver, if appropriate, to learn what they need. You may be able to handle some of their caregiving responsibilities while you are in town. These conversations can help you set clear-cut and realistic goals for the visit. Decide on your top priorities — that may mean reserving other tasks for a future visit.

Because there’s a lot to do during a short visit, it’s easy to overlook simply spending time with the person and doing things together. Try to make time for activities unrelated to being a caregiver, such as watching a movie, playing a game, enjoying music, or taking a drive. Finding time to enjoy something simple and relaxing together is good for everyone.

Supporting the person doing day-to-day caregiving

In many cases, one person takes on most of the everyday responsibilities of caring for an older person. It tends to be a spouse or the child or sibling who lives closest. If you are not the primary caregiver, you can still play an important role in supporting that person.

Here are some ways you can help, even if you don’t live nearby:

• Ask what you can do that would be most helpful.
• Stay in regular contact with the primary caregiver by phone or email. Just listening may not sound like much, but it can mean a lot.
• Travel to stay with the older person for a few days so the primary caregiver can take a vacation or just have some time off.
• Arrange for regular respite care in the form of a volunteer, an in-home aide, or an adult day care program.

In time, the older person may have to move to a residential (live-in) facility, such as assisted living or a nursing home. If that happens, the primary caregiver will need your support. You can work together to select a facility and coordinate the move. The primary caregiver may need extra support while adjusting to the person’s absence and to living alone at home.

To learn more, please visit https://www.nia.nih.gov/health/long-distance-caregiving/what-long-distance-caregiving.

Almost anyone, at any age, can do some type of physical activity. You can still exercise even if you have a health condition like heart disease, arthritis, chronic pain, high blood pressure, or diabetes. In fact, physical activity may help. For most older adults, physical activities like brisk walking, riding a bike, swimming, weightlifting, and gardening are safe, especially if you build up slowly. You may want to talk with your doctor about how your health condition might affect your ability to be active.

Staying physically active: Alzheimer’s disease and related dementias

Researchers are assessing the benefit of exercise to delay mild cognitive impairment (MCI) in older adults and to improve brain function in older adults who may be at risk for developing Alzheimer’s disease. Older adults with MCI may be able to safely do more vigorous forms of exercise, similar to older adults without MCI, provided there are no other underlying health concerns.

Being active and getting exercise may help people with Alzheimer’s or another dementia feel better and can help them maintain a healthy weight and have regular toilet and sleep habits. If you are a caregiver, you can exercise together to make it more fun.

Exercising with arthritis

For people with arthritis, exercise can reduce joint pain and stiffness. It can also help with losing weight, which reduces stress on the joints.

Flexibility exercises such as upper- and lower-body stretching and tai chi can help keep joints moving, relieve stiffness, and give you more freedom of movement for everyday activities.

Strengthening exercises, such as overhead arm raises, will help you maintain or add to your muscle strength to support and protect your joints.

Endurance exercises make the heart and arteries healthier and may lessen swelling in some joints. Try activities that don’t require a lot of weight on your joints, such as swimming and biking.

If you have arthritis, you may need to avoid some types of activity when joints are swollen or inflamed. If you have pain in a specific joint area, for example, you may need to focus on another area for a day or two.

Physical activity and COPD (Chronic Obstructive Pulmonary Disease)

If you have COPD, talk with your healthcare provider or a pulmonary therapist to learn what he or she recommends. You may be able to learn some exercises to help your arms and legs get stronger and/or breathing exercises that strengthen the muscles needed for breathing.

Pulmonary rehabilitation is a program that helps you learn to exercise and manage your disease with physical activity and counseling. It can help you stay active and carry out your day-to-day tasks.

Exercising with type 2 diabetes

For people with diabetes, exercise and physical activity can help manage the disease and help you stay healthy longer. Walking and other forms of daily exercise can help improve glucose levels in older people with diabetes. Set a goal to be more active most days of the week, and create a plan for being physically active that fits into your life and that you can follow. Your healthcare team can help.

A few easy steps to be more active:

• Stretch during TV commercial breaks.
• Walk around when you talk on the phone.
• Take more steps by parking farther away from stores, movie theaters, or your office.

Exercise and heart health

Your heart keeps your body running. As you grow older, some changes in the heart and blood vessels are normal, but others are caused by disease. Choices you might make every day, such as eating healthy, maintaining a healthy weight, and aiming to be more physically active, can contribute to heart health. Inactive people are nearly twice as likely to develop heart disease as those who are active. A lack of physical activity can worsen other heart disease risk factors as well, such as high blood cholesterol and triglyceride levels, high blood pressure, diabetes and prediabetes, and overweight and obesity. Being physically active is one of the most important things you can do to keep your heart healthy. Aim for at least 150 minutes of moderate-intensity aerobic activity a week.

Exercising with osteoporosis

Weight-bearing exercises, which force you to work against gravity, such as walking, jogging, or dancing three to four times a week, are best for building muscle and strengthening bones. Try some strengthening and balance exercises, too, to help avoid falls, which could cause a broken bone. Doing these exercises is good for bone health for people with osteoporosis and those who want to prevent it.

Exercising with chronic pain

Most people living with chronic pain can exercise safely, and it can assist with pain management. In fact, being inactive can sometimes lead to a cycle of more pain and loss of function. Talk to your doctor about what exercises/activities might be right for you. Each type of exercise—endurance, strength, balance, and flexibility—has its own benefits, so a combination may be best.

Exercise can help you maintain a healthy body weight, which may relieve knee or hip pain. Putting on extra weight can slow healing and make some pain worse. Remember to listen to your body when exercising and participating in physical activities. Avoid over-exercising on “good days.” If you have pain, swelling, or inflammation in a specific joint area, you may need to focus on another area for a day or two. If something doesn’t feel right or hurts, seek medical advice right away.

Quick tip

Pain rarely goes away overnight. Talk with your doctor about how long it may take before you feel better. As your pain lessens, you can likely become even more active.

To learn more, please visit https://www.nia.nih.gov/health/exercise-and-physical-activity/exercising-chronic-conditions.

Knowing what matters most to your loved one can help you honor their wishes and give you peace of mind if they become too sick to make decisions. Unfortunately, only one in three people in the United States has a plan for their future health care in place. There are steps you can take to help your friend or family member navigate future medical decisions — and to be prepared to make decisions for them, if needed. This is part of advance care planning, which involves preparing for decisions about future medical care and discussing those wishes with loved ones.

How to start the conversation about advance care planning

One of the best things you can do as a caregiver is to discuss your loved one’s care and treatment preferences in advance. Starting the conversation early is especially important if the person has been diagnosed with a condition that affects their cognitive health, such as Alzheimer’s disease or another form of dementia. Here are some ways you might start the conversation:

• Start simple. Talking about specific medical treatments or decisions can be scary and overwhelming. Instead, try asking about any concerns they may have, what decisions they may need to make, and who they might trust to make decisions for them.
• Share what’s important to you. Your loved one may feel more comfortable discussing their preferences if you talk about what matters to you, as well.
• Remind them why it’s important. Talk about the benefits of having these conversations and creating an advance care plan. By documenting their wishes, they are more likely to get the care they want, and it can also help loved ones feel less burden, guilt, and depression.
• Try to be understanding. After a recent diagnosis or health change, it can be overwhelming and difficult to discuss future health care needs. The person may feel more comfortable talking with someone else such as a doctor or someone in their spiritual community. You can also encourage the person to think about their potential needs and plan to discuss them another time.
• Keep the conversation going. Listen carefully to what the person says and encourage them to continue sharing.

If the person is open to creating an advance care plan, you can provide them information on how to get started. It’s possible your loved one may not want to put a plan in place. Still, talking to them about their preferences can help you prepare for future decisions. You may also be able to help prepare in other ways, for example by getting important papers in order.

How to serve as a health care proxy

Most people ask a close friend or family member to be their health care proxy. A health care proxy is typically responsible for talking with doctors and making decisions about tests, procedures, and treatments if a person is unable to speak for themself. The types of decisions a proxy can make should be outlined clearly in the durable power of attorney for health care, a legal document that names the proxy.

If someone has asked you to be their health care proxy, it’s important to consider whether the role is right for you. You may have to discuss sensitive topics, make difficult decisions, and advocate on the person’s behalf. Ask yourself:

• Can I honor this person’s wishes and values about life, health, health care, and dying? Sometimes this can be challenging if your values are not the same.
• Am I comfortable speaking up on the person’s behalf? It’s okay if you don’t know a lot about health care, but it’s important that you are willing to ask questions and stand up for the person.
• Are you comfortable dealing with conflict? A proxy may need to uphold the person’s wishes even if other family members, friends, or loved ones don’t agree.

If you have agreed to be someone’s health care proxy, consider these tips:

• Talk to the person about their values. Learn what matters most to them when it comes to life, health care, and dying.
• Learn about their current and future health concerns. The more you understand their wishes, the more prepared you will be to make decisions for them when the time comes. Ask if they have any plans in place, like a living will, and walk through it together.
• Ask for a copy of their advance directives. This often includes a living will and durable power of attorney for health care forms.
• Keep a copy of important information. Make sure to have contact information for the person’s health care providers and family members.
• Ask about other considerations. For example, is there anyone other than the medical team that you should talk with when making decisions? Are there spiritual, cultural, or religious traditions the person wants you to consider?
• Continue the conversation. Have conversations each year and as major life changes happen, such as a divorce, death, or change in their health.

Even when you have a person’s decisions in writing and have talked about their wishes, you may still face difficult choices or not be able to follow the person’s wishes exactly. Try to reflect on your discussions and do your best to honor the person’s wishes to the extent possible.

Learn more about the role of a health care proxy.

• What to do when your loved one can no longer make decisions

If your loved one can no longer make their own decisions, you may need to make decisions on their behalf. This can be difficult if you haven’t discussed their preferences before. Even if you have, there may be unexpected situations and decisions that arise. Talking with close loved ones and the person’s health care team can help you prepare and feel more supported when decisions arise. Try to:

• Talk to family members, friends, or others who know the person well.
• Think about how the person lived their life. What values and wishes did they express in the past? What did they find most meaningful in life?
• Talk with the doctor and health care team about what to expect and the types of decisions you may need to make.

Learn more about making decisions for someone at the end of life.

Tips for navigating the health care system

When a person becomes too sick to make decisions for themselves, family members and caregivers may need to navigate the health care system and find ways to advocate for their loved one’s care — especially if a proxy was not named. Use these tips:

• Ask questions. If you are unclear about something you are told, don’t be afraid to ask the doctor or nurse to repeat it or to say it another way.
• Make the person’s wishes clear. Share copies of the person’s advance directives and the proxy’s contact information with the health care team, nursing home staff, or others caring for the person. If the person is still living at home, you can put this information in a colorful envelope near their bed or on the fridge for emergency responders.
• Write down contact information. Ask for a specific person on the medical team that you can contact for questions or if the person needs something.
• Choose one person to make health care choices. Deciding on a main point of contact for the medical team can help everyone stay more organized, coordinate upcoming appointments, and manage medications or changing medical needs.
• Keep family members looped in. Even with one person named as the decision-maker, it is a good idea to have your family agree on the care plan, if possible. If you can’t agree, you might consider working with a mediator, a person trained to bring people with different opinions to a common decision.
• Try to decide on an end-of-life approach. When it becomes clear the person is nearing the end of life, the family should try to discuss the desired end-of-life care approach with the health care team. This might include hospice care. Discussing the options and making decisions as early as possible can help with planning.
• Remind the health care team who the person is. Remind them that the person is not just a patient. Tell them about the person. Share what they were like, discuss the things they enjoyed most, and post pictures in their room.

There may also be people in your community who can help you navigate the health care system. Some hospitals have a patient advocate or care navigator, or you may consider working with a geriatric care manager.

To learn more, please visit https://www.nia.nih.gov/health/advance-care-planning/advance-care-planning-and-health-care-decisions-tips-caregivers-and.

Which vaccines do older adults need?

As you get older, a health care provider may recommend vaccinations, also known as shots or immunizations, to help prevent certain illnesses.

Talk with a doctor or pharmacist about which of the following vaccines you need. Make sure to protect yourself as much as possible by keeping your vaccinations up to date.

COVID-19 vaccines

COVID-19 is a respiratory disease that causes symptoms such as fever, cough, and shortness of breath. Older adults are more likely than younger people to get very sick from COVID-19. The disease can lead to serious illness and death.

Studies show that COVID-19 vaccines reduce the risk of getting this disease. The vaccine will also help keep you from getting seriously ill or having to go to the hospital if you do get COVID-19. We are still learning how effective COVID-19 vaccines are against new variants of the virus. Read more about COVID-19 vaccine effectiveness.

The Centers for Disease Control and Prevention (CDC) recommends that older adults stay up to date with COVID-19 vaccines, including booster shots. Read more about COVID-19 vaccines from the CDC.

The COVID-19 vaccine is available at no cost in the United States. Contact your local health department or visit Vaccines.gov to find out where you can get vaccinated.

Flu vaccine for older adults

Flu — short for influenza — is a virus that can cause fever, chills, sore throat, stuffy nose, headache, and muscle aches. Flu is very serious when it gets in your lungs. Older adults are at a higher risk for developing serious complications from the flu, such as pneumonia.

The flu is easy to pass from person to person. The virus also changes over time, which means you can get it again. To ensure flu vaccines remain effective, the vaccine is updated every year.

Everyone age 6 months and older should get an annual flu vaccine, but the protection from a flu vaccine can lessen with time, especially in older adults. Still, you are less likely to become seriously ill or hospitalized with the flu if you get the vaccine. A flu vaccine is especially important if you have a chronic health condition such as heart disease or diabetes.

Ideally, you should get your vaccine by the end of October each year so you are protected when the flu season starts. It takes at least two weeks for the vaccine to be effective. However, if you have not received your flu vaccine by the end of October, it’s not too late — flu season typically peaks in December or January. As long as the flu virus is spreading, getting vaccinated will help protect you.

There are flu vaccines designed specifically for older adults. The CDC recommends that people age 65 and older receive a higher-dose flu vaccine or an adjuvanted flu vaccine (one with an additional ingredient called an adjuvant that helps create a stronger immune response). These vaccines are potentially more effective than the standard flu vaccine for people in this age group. Talk with a health care provider or pharmacist about which vaccine is best for you.

Medicare will pay for the flu vaccine, and so will private health insurance plans. You can get a flu vaccine at a doctor’s office or local health department, as well as at many grocery stores, drug stores, and pharmacies. Flu shots may also be available at other community locations, such as schools, religious centers, and workplaces. The ingredients of a specific vaccine are the same wherever you receive it.

RSV vaccine for older adults

Respiratory syncytial virus (RSV) is a common virus that usually causes mild, cold-like symptoms. However, older adults have a higher risk of developing severe symptoms if they are infected with RSV. The illness can be particularly dangerous for people who have chronic diseases or a weakened immune system. Older adults who get very sick from an RSV infection may need to be hospitalized, and the illness can even be life-threatening.

RSV vaccines are available to protect older adults from the serious health problems that can occur with RSV infection. The CDC recommends that adults 60 years and older talk with their health care provider about whether they should receive the RSV vaccine. Like the flu, RSV infections are most common in the fall and winter months, so consider getting vaccinated before RSV season starts. However, you can benefit from the RSV vaccine at any time of year.

You can get the RSV vaccine at a doctor’s office, your local health department, and many pharmacies. Medicare Part D and private health insurance plans may pay some or all of the cost. Check with Medicare or your health plan for details about coverage.

Vaccines to help prevent pneumonia

Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs and it can affect other parts of the body. Older adults are at higher risk than younger people of getting very sick or dying from pneumococcal disease.

The CDC recommends that all adults age 65 and older get pneumococcal vaccination. This vaccine helps protect you from getting a serious infection, including pneumonia. There are multiple forms of the pneumococcal vaccine: Talk to a health care provider to find out which is best for you. You can also visit the CDC’s Pneumococcal Vaccination webpage to learn more about the types of vaccines that are available.

Medicare will pay for the pneumococcal vaccine, as will many private insurance plans. You can get the vaccine at a doctor’s office, your local health department, and many pharmacies. Pneumococcal vaccines may also be available at other community locations, such as schools, religious centers, and workplaces.

Tetanus, diphtheria, and pertussis (whooping cough) vaccines

Tetanus, diphtheria, and pertussis are diseases caused by bacteria that can lead to serious illness and death.

• Tetanus (sometimes called lockjaw) is caused by bacteria found in soil, dust, and manure. It can enter the body through a deep cut or burn.
• Diphtheria is a serious illness that can affect the tonsils, throat, nose, or skin. It can spread from person to person.
• Pertussis, also known as whooping cough, causes uncontrollable, violent coughing fits that make it hard to breathe. It can spread from person to person.

Getting vaccinated is the best way to prevent tetanus, diphtheria, and pertussis. Most people get vaccinated as children, but you also need booster shots as you get older to stay protected against these diseases. The CDC recommends that adults get a Tdap (tetanus, diphtheria, and pertussis) or Td (tetanus, diphtheria) booster shot every 10 years. Ask a health care provider when you need your booster shot.

You can get the Tdap or Td vaccine at a doctor’s office, your local health department, and many pharmacies. Medicare Part D and private health insurance plans may pay some or all of the cost. Check with Medicare or your health plan for details about coverage.

Shingles vaccine for older adults

Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. As you get older, the virus could become active again and cause shingles.

Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well as a rash with fluid-filled blisters. Even when the rash disappears, the pain can remain. This is called post-herpetic neuralgia, or PHN.

The shingles vaccine is safe, and it may keep you from getting shingles and PHN. Healthy adults age 50 and older should get vaccinated with the shingles vaccine, Shingrix, which is given in two doses. (Zostavax, an earlier shingles vaccine, is no longer available in the United States.)

You should get a shingles vaccine even if you’ve already had chickenpox or the chickenpox vaccine, or if you don’t remember whether you had chickenpox. You should also get the shingles vaccine if you’ve already had shingles or received Zostavax. However, you should not get a vaccine if you currently have shingles, are sick or have a fever, have a weakened immune system, or have had an allergic reaction to Shingrix. Check with a health care provider if you are not sure what to do.

You can get the shingles vaccine at a doctor’s office, your local health department, and many pharmacies. Medicare Part D and private health insurance plans may pay some or all of the cost. Check with Medicare or your health plan for details about coverage.

Travel vaccines

Check with a doctor, a pharmacist, or your local health department about vaccines you need if you’re planning to travel to other countries. The vaccines that are required and recommended are based on your destination, planned activities, and medical history. Sometimes multiple vaccines or doses are needed. It’s best to get them at least four to six weeks before you travel to allow time to build up immunity and get the best protection, particularly from those that may require multiple doses.

Contact Medicare or your private health insurance plan to find out whether they cover the travel vaccines you need. You may be able to get some travel vaccines from a local health care provider. Others are available from health departments and travel medicine clinics. For more information, visit the CDC Traveler’s Health website or call its information line at 800-232-4636.

Vaccine safety and side effects

Vaccines are very safe, and they can help keep you from getting serious or life-threatening diseases. The most common side effects for all these vaccines are mild and may include pain, swelling, or redness where the vaccine was given.

Before getting any vaccine, talk with a doctor or pharmacist about your health history, including past illnesses and treatments, as well as any allergies. A health care provider can address any concerns you have.

It’s a good idea to keep your own vaccination record, listing the types and dates of your shots, along with any side effects or problems.

To learn more, please visit https://www.nia.nih.gov/health/immunizations-and-vaccines/vaccinations-and-older-adults.

Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. Read this article to find common signs and symptoms of depression, treatment options, and if you or your loved one may be at risk for depression.

What is depression?

Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but clinical depression is not a normal part of aging. In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems than younger people. However, if you’ve experienced depression as a younger person, you may be more likely to have depression as an older adult.

Depression is serious, and treatments are available to help. For most people, depression gets better with treatment. Counseling, medicine, or other forms of treatment can help. You do not need to suffer — help and treatment options are available. Talk with your doctor if you think you might have depression.

There are several types of depression that older adults may experience:

• Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks
• Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks, unlike someone with Major Depressive Disorder
• Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, like alcohol or pain medication
• Depressive Disorder Due to A Medical Condition – depression related to a separate illness, like heart disease or multiple sclerosis.

Other forms of depression include psychotic depression, postmenopausal depression, and seasonal affective disorder. Find detailed descriptions of different types of depression from the National Institute of Mental Health.

Contact someone if you need help

If you are thinking about harming yourself, tell someone who can help immediately.

• Do not isolate yourself.
• Call a trusted family member or friend.
• Call 911 or go to a hospital emergency room to get immediate help.
• Make an appointment with your doctor.

Call the 24-hour 988 Suicide & Crisis Lifeline at 988 or 800-273-TALK (800-273-8255). For TTY, use your preferred relay service or dial 711 then 988.

What are risk factors of depression?

There are many things that may be risk factors of depression. For some people, changes in the brain can affect mood and result in depression. Others may experience depression after a major life event, like a medical diagnosis or a loved one’s death. Sometimes, those under a lot of stress — especially people who care for loved ones with a serious illness or disability — can feel depressed. Others may become depressed for no clear reason.

Research has shown that these factors are related to the risk of depression, but do not necessarily cause depression:

• Medical conditions, such as stroke or cancer
• Genes – people who have a family history of depression may be at higher risk
• Stress, including caregiver stress
• Sleep problems
• Social isolation and loneliness
• Lack of exercise or physical activity
• Functional limitations that make engaging in activities of daily living difficult
• Addiction and/or alcoholism —included in Substance-Induced Depressive Disorder

What are signs and symptoms of depression?

How do you know if you or your loved one may have depression? Does depression look different as you age? Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings.

The following is a list of common symptoms. Still, because people experience depression differently, there may be symptoms that are not on this list.

• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, guilt, worthlessness, or helplessness
• Irritability, restlessness, or having trouble sitting still
• Loss of interest in once pleasurable activities, including sex
• Decreased energy or fatigue
• Moving or talking more slowly
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, waking up too early in the morning, or oversleeping
• Eating more or less than usual, usually with unplanned weight gain or loss
• Thoughts of death or suicide, or suicide attempts

If you have several of these signs and symptoms and they last for more than two weeks, talk with your doctor. These could be signs of depression or another health condition. Don’t ignore the warning signs. If left untreated, serious depression may lead to death by suicide.

If you are a health care provider of an older person, ask how they are feeling during their visits. Research has shown that intervening during primary care visits is highly effective in reducing suicide later in life. If you are a family member or friend, watch for clues. Listen carefully if someone of any age says they feel depressed, sad, or empty for long periods of time. That person may really be asking for help. Knowing the warning signs for suicide and how to get help. It can help save lives.

Depression can look different depending on a person’s cultural background

Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders — including depression — in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems.

Supporting friends and family with depression

Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.

As a friend or family member of a person with depression, here are a few things you can do:

• Encourage the person to seek medical treatment and stick with the treatment plan the doctor prescribes.
• Help set up medical appointments or accompany the person to the doctor’s office or a support group.
• Participate in activities the person likes to do.
• Ask if the person wants to go for a walk or a bike ride. Physical activity can be great for boosting mood.

How is depression treated?

Depression, even severe depression, can be treated. It’s important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider.

Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests. If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test. This evaluation will help determine a diagnosis and a treatment plan.

Common forms of treatment for depression include:

• Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional. Examples of approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
• Medications for depression that may balance hormones that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.
• Electroconvulsive Therapy (ECT), during which electrodes are placed on a person’s head to enable a safe, mild electric current to pass through the brain. This type of therapy is usually considered only if a person’s illness has not improved with other treatments.
• Repetitive transcranial magnetic stimulation (rTMS), which uses magnets to activate the brain. rTMS does not require anesthesia and targets only specific regions of the brain to help reduce side effects such as fatigue, nausea, or memory loss that could happen with ECT.

Medication and older adults

As you get older, body changes can affect the way medicines are absorbed and used. Because of these changes, there can be a larger risk of drug interactions among older adults. Share information about all medications and supplements you’re taking with your doctor or pharmacist. Use this worksheet to help track your medications.

Treatment, particularly a combination of psychotherapy and medications, has been shown to be effective for older adults. However, not all medications or therapies will be right for everyone. Treatment choices differ for each person, and sometimes multiple treatments must be tried in order to find one that works. It is important to tell your doctor if your current treatment plan isn’t working and to keep trying to find something that does.

Some people may try complementary health approaches, like yoga, to improve well-being and cope with stress. However, there is little evidence to suggest that these approaches, on their own, can successfully treat depression. While they can be used in combination with other treatments prescribed by a person’s doctor, they should not replace medical treatment. Talk with your doctor about what treatment(s) might be good to try.

Don’t avoid getting help because you don’t know how much treatment will cost. Treatment for depression is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment based on a person’s ability to pay.

Depression in people with dementia

Depression is common in people with Alzheimer’s and related dementias. Dementia can cause some of the same symptoms as depression, and depression can be an early warning sign of possible dementia. Suicide attempts may also increase in people recently diagnosed with dementia. It is important to have support systems in place to help cope with a dementia diagnosis and possible depression symptoms that follow. More research is needed to determine effective depression treatment options for people with dementia.

Can depression be prevented?

Many people wonder if depression can be prevented and how they may be able to lower their risk of depression. Although most cases of depression cannot be prevented, healthy lifestyle changes can have long-term benefits to your mental health.

Here are a few steps you can take:

• Be physically active and eat a healthy, balanced diet. This may help avoid illnesses that can bring on disability or depression. Some diets — including the low-sodium DASH diet — have been shown to reduce risk of depression.
• Get 7-9 hours of sleep each night.
• Stay in touch with friends and family.
• Participate in activities you enjoy.
• Let friends, family, and your physician know when you’re experiencing symptoms of depression.

To learn more, please visit https://www.nia.nih.gov/health/mental-and-emotional-health/depression-and-older-adults.

HOW DOES THE HEART WORK?

Your heart is a strong muscle that pumps blood to your body. A normal, healthy adult heart is about the size of your clenched fist. Just like an engine makes a car go, the heart keeps your body running. The heart has two sides, each with a top chamber (atrium) and a bottom chamber (ventricle). The right side pumps blood to the lungs to pick up oxygen. The left side receives blood rich with oxygen from the lungs and pumps it through arteries throughout the body. An electrical system in the heart controls the heart rate (heartbeat or pulse) and coordinates the contraction of the heart’s top and bottom chambers.

HOW YOUR HEART CHANGES WITH AGE

People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.

Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can’t beat as fast during physical activity or times of stress as it did when you were younger. However, the number of heartbeats per minute (heart rate) at rest does not change significantly with normal aging.

Changes that happen with age may increase a person’s risk of heart disease. A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things you can do to delay, lower, or possibly avoid or reverse your risk.

The most common aging change is increased stiffness of the large arteries, called arteriosclerosis (ahr-teer-ee-o-skluh-roh-sis), or hardening of the arteries. This causes high blood pressure, or hypertension, which becomes more common as we age.

High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up inside the walls of your arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.

Age can cause other changes to the heart. For example:

• There are age-related changes in the electrical system that can lead to arrhythmias—a rapid, slowed, or irregular heartbeat—and/or the need for a pacemaker. Valves—the one-way, door-like parts that open and close to control blood flow between the chambers of your heart—may become thicker and stiffer. Stiffer valves can limit the flow of blood out of the heart and become leaky, both of which can cause fluid to build up in the lungs or in the body (legs, feet, and abdomen).
• The chambers of your heart may increase in size. The heart wall thickens, so the amount of blood that a chamber can hold may decrease despite the increased overall heart size. The heart may fill more slowly. Long-standing hypertension is the main cause of increased thickness of the heart wall, which can increase the risk of atrial fibrillation, a common heart rhythm problem in older people.
• With increasing age, people become more sensitive to salt, which may cause an increase in blood pressure and/or ankle or foot swelling (edema).

Other factors, such as thyroid disease or chemotherapy, may also weaken the heart muscle. Things you can’t control, like your family history, might increase your risk of heart disease. But, leading a heart-healthy lifestyle might help you avoid or delay serious illness.

WHAT IS HEART DISEASE?

Heart disease is caused by atherosclerosis (ath-uh-roh-skluh-roh-sis), which is the buildup of fatty deposits, or plaques, in the walls of the coronary arteries over many years. The coronary arteries surround the outside of the heart and supply blood nutrients and oxygen to the heart muscle. When plaque builds up inside the arteries, there is less space for blood to flow normally and deliver oxygen to the heart. If the flow of blood to your heart is reduced by plaque buildup or is blocked if a plaque suddenly ruptures, it can cause angina (chest pain or discomfort) or a heart attack. When the heart muscle does not get enough oxygen and blood nutrients, the heart muscle cells will die (heart attack) and weaken the heart, diminishing its ability to pump blood to the rest of the body.

Find out more about heart attacks.

SIGNS OF HEART DISEASE

Early heart disease often doesn’t have symptoms or the symptoms may be barely noticeable. That’s why regular checkups with your doctor are important.

Contact your doctor right away if you feel any chest pain, pressure, or discomfort. However, chest pain is a less common sign of heart disease as it progresses, so be aware of other symptoms. Tell your doctor if you have:

• Pain, numbness, and/or tingling in the shoulders, arms, neck, jaw, or back
• Shortness of breath when active, at rest, or while lying flat
• Chest pain during physical activity that gets better when you rest
• Lightheadedness
• Dizziness
• Confusion
• Headaches
• Cold sweats
• Nausea/vomiting
• Tiredness or fatigue
• Swelling in the ankles, feet, legs, stomach, and/or neck
• Reduced ability to exercise or be physically active
• Problems doing your normal activities

Problems with arrhythmia are much more common in older adults than younger people. Arrhythmia needs to be treated. See a doctor if you feel a fluttering in your chest or have the feeling that your heart is skipping a beat or beating too hard, especially if you are weaker than usual, dizzy, tired, or get short of breath when active.

If you have any signs of heart disease, your doctor may send you to a cardiologist, a doctor who specializes in the heart.

WHAT CAN I DO TO PREVENT HEART DISEASE?

There are many steps you can take to keep your heart healthy.

Try to be more physically active. Talk with your doctor about the type of activities that would be best for you. If possible, aim to get at least 150 minutes of physical activity each week. Every day is best. It doesn’t have to be done all at once.

Start by doing activities you enjoy—brisk walking, dancing, bowling, bicycling, or gardening, for example. Avoid spending hours every day sitting.

If you smoke, quit. Smoking is the leading cause of preventable death. Smoking adds to the damage to artery walls. It’s never too late to get some benefit from quitting smoking. Quitting, even in later life, can lower your risk of heart disease, stroke, and cancer over time.

Follow a heart-healthy diet. Choose foods that are low in saturated fats, added sugars, and salt. As we get older, we become more sensitive to salt, which can cause swelling in the legs and feet. Eat plenty of fruits, vegetables, and foods high in fiber, like those made from whole grains. Get more information on healthy eating from NIA. You also can find information on the Dietary Approaches to Stop Hypertension (DASH) eating plan and the U.S. Department of Agriculture’s Food Patterns.

Keep a healthy weight. Balancing the calories you eat and drink with the calories burned by being physically active helps to maintain a healthy weight. Some ways you can maintain a healthy weight include limiting portion size and being physically active. Learn more about how to maintain a healthy weight from NIA.

Keep your diabetes, high blood pressure, and/or high cholesterol under control. Follow your doctor’s advice to manage these conditions, and take medications as directed.

Don’t drink a lot of alcohol. Men should not have more than two drinks a day and women only one. One drink is equal to:

• One 12-ounce can or bottle of regular beer, ale, or wine cooler
• One 8- or 9-ounce can or bottle of malt liquor
• One 5-ounce glass of red or white wine
• One 1.5-ounce shot glass of distilled spirits like gin, rum, tequila, vodka, or whiskey

Manage stress. Learn how to manage stress, relax, and cope with problems to improve physical and emotional health. Consider activities such as a stress management program, meditation, physical activity, and talking things out with friends or family. To learn more about stress management techniques, visit the National Center for Complementary and Integrative Health.

THE FUTURE OF RESEARCH ON AGING AND THE HEART

Adults age 65 and older are more likely than younger people to suffer from cardiovascular disease, which is problems with the heart, blood vessels, or both. Aging can cause changes in the heart and blood vessels that may increase a person’s risk of developing cardiovascular disease.

To understand how aging is linked to cardiovascular disease so that we can ultimately develop cures for this group of diseases, we need to first understand what is happening in the healthy but aging heart and blood vessels. This understanding has advanced dramatically in the past 30 years.

Learn more about The Heart Truth®, a national heart disease awareness campaign for women from the National Heart, Lung, and Blood Institute.

Today, more than ever, scientists understand what causes your blood vessels and heart to age and how your aging cardiovascular system leads to cardiovascular disease. In addition, they have pinpointed risk factors that increase the odds a person will develop cardiovascular disease. They are learning much more about how physical activity, diet, and other lifestyle factors influence the “rate of aging” in the healthy heart and arteries. The aging of other organ systems, including the muscles, kidneys, and lungs, also likely contributes to heart disease. Research is ongoing to unravel how these aging systems influence each other, which may reveal new targets for treatments.

In the future, interventions or treatments that slow accelerated aging of the heart and arteries in young and middle-aged people who seem to be healthy could prevent or delay the onset of heart disease, stroke, and other cardiovascular disorders in later life. Some interventions that we already know slow the rate of aging in the heart and arteries include healthy eating, exercise, reducing stress, and quitting smoking. The more we understand the changes that take place in cells and molecules during aging, for example, the closer we get to the possibility of designing drugs that target those changes. Gene therapies can also target specific cellular changes and could potentially be a way to intervene in the aging process. While waiting for these new therapies to be developed, you can still enjoy activities, like exercise and a healthy diet, that can benefit your heart.

To learn more, please visit https://www.nia.nih.gov/health/heart-health/heart-health-and-aging.Heart Health and Aging

Many people make assumptions about aging, what it is like to grow “old,” and how older age will affect them. But as we get older, it is important to understand the positive aspects of aging as well as its challenges. Research has shown that most individuals can help preserve their health and mobility as they age by adopting or continuing healthy habits and lifestyle choices. Read on to learn about 10 common misconceptions related to aging and older adults.

1. Are depression and loneliness normal in older adults?

Depression is not a normal part of aging. However, as people age, some may find themselves feeling isolated and alone. This can lead to feelings of depression, anxiety, and sadness. Persistent feelings of depression and loneliness can lead to a decline in physical and mental functioning. These feelings are not normal and shouldn’t be treated as such.

Growing older can have many emotional benefits, such as long-lasting relationships with friends and family and a lifetime of memories to share with loved ones. In fact, some studies show that older adults are less likely to experience depression than young adults. However, it’s important to know that older adults with depression may have less obvious symptoms or be less likely to discuss their feelings. Depression is a common and potentially serious mood disorder, but there are treatments that are effective for most people.

Learn more about depression and older adults and get tips for staying connected.

Get Immediate Help

If you are thinking about harming yourself, tell someone immediately who can help.

• Do not isolate yourself.
• Call 988 or go directly to a hospital emergency room.
• Call your doctor or ask a friend or family member to help you.

Call or text the 24-hour 988 Suicide & Crisis Lifeline: 988 or 800-273-TALK (800-273-8255). For TTY users, use your preferred relay service or dial 711, then 988.

2. Do people need less sleep as they get older?

Older adults need the same amount of sleep as other adults: seven to nine hours each night. However, the quality and quantity of sleep can decline with age. Older adults may find themselves having a harder time falling asleep and staying asleep. Getting enough sleep can help most people stay healthy and alert. Adequate sleep can also help reduce the risk of falls, improve overall mental well-being, and have many other benefits.

Learn more about the importance of getting a good night’s sleep.

3. Can older adults still learn new things?

Yes! Older adults still have the ability to learn something new, create new memories, and improve their performance in a variety of skills. While aging does often come with changes in thinking, many cognitive changes are positive, such as having more knowledge and insight from a lifetime of experiences.

Trying and learning new skills may even improve cognitive abilities. For example, one study found that older adults who learned quilting or digital photography had improved memory. Seeking out new social connections with others and engaging in social activities, such as a dance class or book club, can keep your brain active and may also boost your cognitive health.

Learn more about cognitive health and older adults.

4. Is it inevitable that older people will develop dementia?

No, dementia is not a normal part of aging. Although the risk of dementia increases as people grow older, it is not inevitable, and many people live into their 90s and beyond without the significant declines in thinking and behavior that characterize dementia. About one-third of people over age 85 develop some form of dementia, meaning that about two-thirds do not. Occasionally forgetting an appointment or losing your keys are typical signs of mild forgetfulness, which is a common part of normal aging. Nevertheless, talk with a doctor if you have concerns about your memory and thinking, or notice changes in your behavior and personality. These problems can have a range of different causes, some of which are treatable or reversible. Finding the cause is important for determining best next steps.

Learn more about what’s normal forgetfulness and what’s not.

5. Should older adults avoid exercise and physical activity so they don’t get injured?

Exercise and physical activity can be good for a person’s health at any age! As people age, they may think exercise could do more harm than good, especially if they have a chronic condition. However, studies show that most people have a lot more to gain by being active — and a lot to lose by sitting too much. Often, being sedentary or inactive is more to blame than age when older adults lose the ability to do things on their own.

Almost anyone, at any age and with most health conditions, can participate in some type of exercise or physical activity. In fact, exercise and physical activity may help manage some chronic conditions. Staying active can be great for a person’s mental and physical health. Tai Chi and similar mind-body movement practices have been shown to improve balance and stability in older adults, which can help maintain independence and prevent falls. Resistance training, such as using exercise bands, is also an effective way to build muscle and reduce the risk of falling.

Learn more about how exercise and physical activity can improve your health.

6. If a family member has Alzheimer’s disease, will I develop it, too?

A person’s chance of developing Alzheimer’s disease may be higher if they have a family history of dementia because some genetic variants are known to increase risk. However, having a parent or other close family member with Alzheimer’s does not necessarily mean that a person will develop the disease. Learn about your own unique family health history and talk with your doctor about any concerns.

In most cases, a person’s risk of Alzheimer’s is influenced by a combination of factors, including the effects of multiple genes. Environmental, lifestyle, and health factors — such as hypertension, exercise, diet, exposure to pollutants, and smoking — can also affect a person’s risk. While inherited genes are beyond control, people can take steps to stay healthy as they age, such as getting regular exercise, managing high blood pressure, and not smoking.

Learn more about Alzheimer’s genetics and what we know about preventing Alzheimer’s.

7. Now that I’m older, will I have to give up driving?

Not necessarily. Physical and cognitive changes can occur with age that may affect a person’s ability to drive. These may include slower reactions, diminished vision or hearing, and reduced strength or mobility. However, not all people experience these changes and may still be safe behind the wheel in their later years. As the U.S. population ages, the number of licensed older adults on the road will continue to increase. In 2020, there were 48 million licensed drivers over the age of 65, a 68% increase from 2000. The question of when it is time to limit or stop driving should not be about age; rather, it should be about one’s ability to drive safely. This article can help determine if you or a loved one needs to limit or stop driving. Talk with your doctor about any health and driving concerns.

Learn more about driving safety and older adults.

8. Is osteoporosis only a problem for women?

No, although osteoporosis — a condition that makes bones more fragile and prone to breaking — is more common in women, this disease also affects and could be underdiagnosed in men. While men may not be as likely to have osteoporosis because they start with higher bone density than women, one in five men over the age of 50 will have an osteoporosis-related fracture. By age 65 or 70, men and women lose bone mass at the same rate.

Many of the factors that put men at risk are the same as those for women, including family history, insufficient calcium or vitamin D, and too little weight-bearing exercise. Low levels of testosterone, too much alcohol, taking certain drugs, and smoking are other risk factors.

Learn more about osteoporosis and how to maintain bone health as you age.

9. Am I “too old” to quit smoking?

No matter how old you are or how long you have been smoking, quitting at any time improves your health. Benefits to quitting may include fewer illnesses such as colds and the flu, breathing more easily, and having more energy.

Some of the benefits of quitting are almost immediate. Within a few hours, the carbon monoxide level in your blood begins to decline and, in a few weeks, circulation improves and lung function increases. Over time, quitting can also lower heart rate and blood pressure. Additionally, quitting smoking lowers the risk of cancer, heart attack, stroke, and lung disease. Quitting will also reduce risks related to secondhand smoke exposure for other family members or caregivers in the home. It is never too late to reap the benefits of quitting smoking and set a healthy example for your family and friends.

Learn more about how to quit smoking and where to find help.

10. If my blood pressure goes down, can I stop taking my medication?

High blood pressure is a very common problem in older adults — especially those in their 80s and 90s — and can lead to serious health problems if not treated properly. If you take blood pressure medicine and your blood pressure goes down, it means your medicine is working. However, it is very important to continue treatment long-term. If you stop taking your medicine, your blood pressure could rise again, increasing the risk for health problems such as stroke and kidney disease. Make sure to have your blood pressure checked regularly and work with your doctor to help keep it under control.

Learn more about high blood pressure and how to help control it.

To learn more, please visit https://www.nia.nih.gov/health/healthy-aging/10-common-misconceptions-about-aging.

Too much heat is not safe for anyone. It is even riskier if you are older or have health problems. It is important to be cautious and get relief quickly when you are overheated. Otherwise, you might start to feel sick or risk a heat-related illness that could cause serious health issues.

Why can extreme weather be even more dangerous for older adults than for younger people? Hotter days can cause difficulty in the body’s ability to regulate its temperature. This can be challenging for older adults who typically do not adjust as well as others to sudden temperature changes. Additionally, older adults are more likely to have chronic medical conditions that affect the body’s response to temperature, and to take prescription medicines that alter the body’s ability to control temperature or sweat.

Heat-related illnesses

Being overheated for too long or being exposed without protection to the sun can cause many health problems. Heat-related illnesses include the following:

• Heat syncope is a sudden dizziness that can happen when you are active in hot weather. If you take a heart medication called a beta blocker or are not acclimated to hot weather, you are even more likely to feel faint. Rest in a cool place, put your legs up, and drink water to make the dizzy feeling go away.
• Heat cramps are the painful tightening or spasms of muscles in your stomach, arms, or legs. Cramps can result from hard work or intense exercise. Though your body temperature and pulse usually stay normal during heat cramps, your skin may feel moist and cool. Stop the physical activity you’re doing and rest in the shade or in a cool building. Drink plenty of fluids, such as water and sports drinks containing electrolytes. Do not consume alcohol or caffeinated beverages.
• Heat edema is a swelling in your ankles and feet when you get hot. Put your legs up to help reduce swelling. If that doesn’t work fairly quickly, check with your doctor.
• Heat rash is a skin irritation from heavy sweating. It causes red clusters of small blisters that look similar to pimples on the skin. Your skin may feel itchy or you may feel “prickly” tingling pain. Keep the infected area dry, use powder to sooth the rash, and stay in cool areas.
• Heat exhaustion is a warning that your body can no longer keep itself cool. You might feel thirsty, dizzy, weak, uncoordinated, and nauseated. You may sweat a lot. Your body temperature may stay normal, but your skin may feel cold and clammy. Some people with heat exhaustion have a rapid pulse. Rest in a cool place and get plenty of fluids. If you don’t feel better soon, get medical care. Be cautious because heat exhaustion can progress to heat stroke.
• Heat stroke is a medical emergency in which the body’s temperature rises above 104°F. Signs of heat stroke are fainting; confusion or acting strangely; not sweating even when it’s hot; dry, flushed skin; strong, rapid pulse; or a slow, weak pulse. When a person has any of these symptoms, they should seek medical help right away and immediately move to a cooler place, such as under shade or indoors. They should also take action to lower their body temperature with cool clothes, a cool bath or shower, and fans.
• Sun exposure, also known as sunburn, is a sign of skin damage due to extreme or long exposure. Your skin may appear red and tender, develop blisters, start to peel, and be warm to the touch. Severe reactions may cause fever, chills, nausea, or rash. Prevent sunburn by wearing protective clothing that covers your skin and staying out of direct sunlight. Using a broad spectrum sunscreen with an SPF of 15 or higher can also help prevent sunburns, but be sure to reapply often. If you are sunburned, wear lightweight clothing, take cool showers, moisturize affected areas, and stay out of the sun so your skin can heal.

If you are concerned about any of these heat-related illnesses, talk with your doctor.

Check the weather

If the temperature is rising, you may be at increased risk for a heat-related illness. Play it safe by planning ahead for hot days. Visit www.weather.gov, tune in to local radio or TV stations, or check the weather app on your smart phone regularly for forecasts. In addition to the thermometer, pay attention to the heat index, which considers both air temperature and humidity levels, to determine what the temperature actually feels like.

What raises the risk of heat-related illnesses for older adults?

Older adults are at higher risk for heat-related illnesses and death. Factors that put older adults at greater risk may include:

• Health problems such as cardiovascular, lung, or kidney disease
• Changes in skin caused by normal aging
• Any illness that causes weakness or results in a fever
• Taking drugs such as diuretics, sedatives, tranquilizers, and some heart and high blood pressure medicines that may make it harder for the body to cool itself
• Being on several prescription drugs at the same time
• Having obesity, overweight, or underweight
• Drinking alcoholic beverages
• Living in places without air conditioning or fans
• Becoming dehydrated

Tips to stay safe in hot weather

Things you can do to lower your risk of heat-related illness:

• Drink plenty of liquids, such as water, fruit or vegetable juices, or drinks that contain electrolytes. Avoid alcohol and caffeinated beverages. If your doctor has told you to limit your liquids, ask what you should do when it is very hot.
• If you live in a home without air conditioning or fans, try to keep your space as cool as possible. Limit use of the oven; keep shades, blinds, or curtains closed during the hottest part of the day; and open windows at night.

• If your living space is hot, try to spend time during midday in a place that has air conditioning. For example, go to the shopping mall, movies, library, senior center, or a friend’s home. You may also contact your local health department or city to find out if they have air-conditioned shelters in your area.
• If you need help getting to a cooler place, ask a friend or relative. Some religious groups, senior centers, and Area Agencies on Aging provide this service. Search the Eldercare Locator to find services in your area. You could also consider taking a taxi or other car service or calling your local government to see if they offer senior transportation. Don’t stand outside in the heat waiting for a bus.
• Dress for the weather. Wear lightweight, light-colored, loose-fitting clothing. Natural fabrics such as cotton may feel cooler than synthetic fibers.
• Avoid outdoor exercising and other physical activity when it is very hot. Instead, try to find someplace you can be active while staying cool indoors.
• If you must go outside, try to limit your time out and avoid crowded places. Plan trips during non-rush-hour times.
• Make sure to use a broad spectrum sunscreen, SPF 15 or higher, and reapply it throughout the day, especially if your skin will have continuous exposure to the sun. Wear a hat and other protective clothing, and sunglasses. If you do get sunburned, stay out of the sun until your skin is healed and use cool cloths and moisturizers to treat the affected area.
• Ask your doctor if any of your medications make you more likely to become overheated or sunburned.

Key points to remember about hot weather safety

Older people can have a tougher time dealing with heat and humidity. The temperature inside or outside does not have to be high to put them at risk for a heat-related illness.

Headache, confusion, dizziness, or nausea could be a sign of a heat-related illness. Go to the doctor or to an emergency room to find out if you need treatment.

To keep heat-related illnesses from becoming a dangerous heat stroke, remember to:

• Get out of the sun and into a cool, ideally air-conditioned place.
• Drink fluids but avoid alcohol and caffeine.
• Shower, bathe, or sponge off with cool water.
• Lie down and rest.

To learn more, visit https://www.nia.nih.gov/health/safety/hot-weather-safety-older-adults.

Long-term care involves a variety of services designed to meet a person’s health or personal care needs when they can no longer perform everyday activities on their own. This article provides an overview of long-term care planning, services, and costs, as well as other resources.

Who needs long-term care?

Many people will need long-term care at some point. However, it can be difficult to predict how much or what type of care a person might need.

The need for long-term care can arise suddenly, such as after a heart attack or stroke. More often, however, the need for long-term care develops gradually. People require more care as they get older and frailer or as a serious, ongoing illness or health condition gets worse.

Healthy habits can reduce the risk of many diseases and may help delay or prevent the need for long-term care. Good nutrition, regular physical activity, not smoking, and limited drinking of alcohol can help you stay healthy. So can an active social life, a safe home, and regular health care. Talk to your health care provider about your medical and family history and lifestyle. They may suggest actions you can take to improve your health.

What are the different types of long-term care services?

Long-term care involves a wide variety of support services to help people live as independently and safely as possible. It is provided in different places by different caregivers, depending on a person’s needs.

Home-based care

In many cases, long-term care is provided at home by informal caregivers, such as family members, friends, and neighbors. Most home-based care services involve personal care — help with everyday activities, also called “activities of daily living.” These activities include bathing, dressing, eating, and taking medications, as well as supervision to make sure a person is safe.

Home-based care can also be supplemented by formal caregivers who are paid for their services. These caregivers include nurses, home health care aides, therapists, and other professionals. They can help older people with many aspects of health care, including giving medications, caring for wounds, helping with medical equipment, and providing physical therapy.

Get detailed information about in-home support services, including suggestions for arranging them, information about costs, and additional resources.

Community and residential care

Some aspects of long-term care can be provided in a person’s community, such as in an adult day care center or senior center. Care in these settings may include meals, exercise, social activities, personal care, and transportation. These services may be provided at no cost or for a fee.

Long-term care can also be given in a residential facility, such as assisted living or a nursing home. Some facilities offer only housing and housekeeping, but many also provide personal care, social and recreational activities, meals, and medical services. Some facilities offer special programs for people with Alzheimer’s disease and other types of dementia.

Long-term care planning

The best time to think about long-term care is before you need it. Planning for the possibility of long-term care gives you and your family time to learn about services available in your community and what they cost. It also allows you to make important decisions while you are still able.

Begin by thinking about what would happen if you became seriously ill or disabled. Talk with your family, friends, and lawyer about who would provide care if you needed help for a long time and what kind of care you would want. People with Alzheimer’s disease and other types of dementia should begin planning for long-term care as soon as possible. Read more about advance care planning.

Most people prefer to stay in their own home for as long as they can. Staying in your own home as you get older is called “aging in place.” But living at home as you age requires careful consideration and planning. There may come a time when it’s no longer safe or comfortable to live alone. Be realistic and plan to revisit the decision as your needs change over time.

Paying for long-term care

Long-term care can be expensive. How people pay for care depends on their financial situation, their eligibility for assistance programs, and the kinds of services they use. People often rely on a variety of payment sources, including:

• Personal funds, including savings, a pension or other retirement fund, income from investments, or proceeds from the sale of a home.
• Federal and state government programs, such as Medicare, Medicaid, and the U.S. Department of Veterans Affairs (VA). Visit Benefits.gov for more information about government programs for health care and financial assistance.
• Private financing, including long-term care insurance, reverse mortgages, certain life insurance policies, annuities, and trusts.

Learn more about paying for long-term care.