Physical activity is essential for healthy aging, and it can be beneficial at any stage of life. Some potential benefits are immediate, such as reduced feelings of anxiety, reduced blood pressure, and improved sleep. Others are long term and require consistent physical activity over time, such as reduced risk of cardiovascular disease, type 2 diabetes, and some cancers.

Importance of an active lifestyle for older adults

It’s never too late to start being physically active and to achieve the benefits of an active lifestyle. Older adults can benefit from all three types of exercise: aerobic, muscle-strengthening, and balance. Many activities, from exercise programs to household tasks, can count towards the 150 minutes of moderate-intensity aerobic activity and two days of muscle-strengthening activities recommended each week.

Physical activity can be an opportunity to participate in activities you enjoy, spend time with friends and family, get outdoors, improve fitness, and maintain a healthy weight. Additionally, being physically active as an older adult may improve your health and health-related quality of life. Active older adults also tend to live longer!

Functional ability and fall prevention

Physical activity improves physical function, making it easier to perform tasks of daily living — including household chores, getting into or out of a bed or chair, and moving around the neighborhood. This increased functional ability can help maintain independence and support independent living for older adults.

Movement and exercise may offer protection against osteoporosis and age-related loss of muscle mass, strength, and function, also known as sarcopenia. The health and functional ability of bones and muscles are especially important for older adults, who are at higher risk for falls and fall-related injuries. Improved physical function can reduce the risk of falls and likelihood of serious injury if there is a fall.

Disease risk and chronic health conditions

Physical activity helps to prevent certain diseases and chronic health conditions that are common among older adults. Older adults who are physically active have a lower risk of:

• Cardiovascular disease (including heart disease and stroke) and death caused by it
• High blood pressure
• Type 2 diabetes
• High cholesterol
• Obesity
• Cancers of the bladder, breast, colon, endometrium, esophagus, kidney, lung, and stomach
• Dementia (including Alzheimer’s disease)
• Depression

Being active can also help to slow or manage chronic disease and to delay death. For older adults who are managing a diagnosis, exercising with chronic conditions can improve quality of life and reduce the risk of developing new health conditions.

Mental and emotional health

Physical activity supports emotional and mental health in addition to physical health. Physical activity can help reduce feelings of depression and anxiety, improve sleep, and benefit overall emotional well-being. It may also improve or maintain some aspects of cognitive function, such as your ability to shift quickly between tasks, plan an activity, and ignore irrelevant information. Older adults who exercise with others get the added benefit of social connection as well.

Try these exercise ideas and see how you feel!

• Walking, bicycling, or dancing. Endurance activities increase your breathing, get your heart pumping, and boost chemicals in your body that may improve mood.
• Yoga. This mind and body practice typically combines physical postures, breathing exercises, and relaxation.
• Tai Chi. This “moving meditation” involves shifting the body slowly, gently, and precisely, while breathing deeply.
• An activity you enjoy. Whether it’s gardening, playing tennis, kicking around a soccer ball with your grandchildren, or something else, choose an activity that you want to do, not have to do.

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

As a primary care practitioner, you likely have long-established relationships with some of your patients and are in an ideal position to observe potential signs of a cognitive problem. You and your staff are often the first to address a patient’s or family’s concerns about cognitive as well as behavioral and functional changes that may have already affected their lives and resulted in, for example, a motor vehicle accident or being the victim of identity theft or financial fraud.^(1, 2) It’s important to take concerns seriously and to assess the person as early as possible to determine the potential cause of impairment. This quick guide features information about assessing cognitive, behavioral, and functional changes in older adults.

Why is it important to assess cognitive impairment in older adults?

It’s important to address any changes in an older person’s memory, language abilities, or personality as these may reflect a neurodegenerative disease process that may either be due to a reversible cause or become more serious. Whether memory or other cognition concerns are reported by the patient or a family member, or directly observed by you, the issues should be noted in the patient’s chart and followed up with a cognitive, behavioral and/or functional assessment.

Cognitive impairment in older adults has a variety of possible causes, including medication side effects; metabolic and/or endocrine dysfunction; delirium due to illness (such as a urinary tract or COVID-19 infection); depression; and dementia, including Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal disorders. Some causes, like medication side effects and depression, can be reversed or improved with treatment. Others, such as Alzheimer’s, cannot be reversed, but symptoms may be treatable for a period of time. It is important to help prepare patients and their families for additional changes that come as cognitive impairment progresses.

Many people who are developing dementia or already have it do not receive a diagnosis. One study found that more than 50% of patients with dementia had not received a clinical cognitive evaluation by a physician.⁽³⁾ Another study showed that physicians were unaware of cognitive impairment in more than 40% of their cognitively impaired patients.⁽⁴⁾ Yet another analysis looking at undetected dementia globally found the U.S. rate to be 61%.⁽⁵⁾ The problem of underdiagnosis is even more pronounced in underserved populations and in those with lower educational attainment.^(6, 7) The failure to evaluate memory or cognitive complaints is likely to hinder treatment of underlying disease and comorbid conditions, and may present safety issues for the patient and others.^(8, 9) In many cases, the cognitive problem will worsen over time and may lead to preventable hospitalizations.^{(2, 8, 10, 11)}

Some older people have mild cognitive impairment (MCI). People living with MCI have more memory problems than is normal for their age, but their symptoms do not interfere significantly with their everyday lives. Older people with MCI are at greater risk for developing Alzheimer’s, but not all of them do. Some may even go back to normal cognition. It is important to determine the cause of the impairment to anticipate future needs, address any reversible causes, and try to mediate modifiable risk factors.

Most people with memory, other cognitive, or behavioral complaints want a diagnosis to understand the nature of their problem and to know what to expect.^{(10, 12, 13, 14, 15)} In a survey conducted by the Alzheimer’s Association of 2,434 U.S. adults age 18 and older, 85% of respondents said they would want to know early if they had Alzheimer’s. Reasons for wanting to know included planning for the future, allowing for earlier treatment of symptoms, taking steps to preserve existing cognitive function, and being able to understand what is happening.⁽¹⁶⁾

Some people are reluctant to mention concerns about memory or other cognitive or behavioral issues because they fear a diagnosis of dementia and how the disease will impact their lives in the future. In these cases, a primary care provider can explain the benefits of finding out what may be causing the person’s health concerns.

While pharmacological treatment options for Alzheimer’s-related memory loss and other cognitive symptoms are limited, there are medicines approved by the U.S. Food and Drug Administration to help manage symptoms, as well as newer medicines granted Accelerated Approval to treat Alzheimer’s. Learn more about these medications in NIA’s How Is Alzheimer’s Disease Treated?

In addition, there are non-drug strategies that can promote physical and emotional comfort. Assessing cognitive impairment and identifying its cause, particularly at an early stage, is beneficial so patients and families can learn about these strategies and develop a care plan in concert with their health care providers.

Clinical trials or other research studies are also an option for people with cognitive impairment. Patients may be interested in participating in clinical trials not only for themselves but also because of the potential to help future generations. Visit the Alzheimers.gov Clinical Trials Finder for more information.

Benefits of early assessment

If assessment is negative, meaning there is no evidence of cognitive impairment: Concerns may be alleviated, at least at that point in time, and it is useful for both the person with concerns as well as the clinician to have a baseline for future assessments.

If assessment is positive and further evaluation is warranted: The patient and physician can take the next step of identifying the cause of impairment because medical conditions such as tumors, vitamin deficiencies, or medication side effects can also cause serious memory problems that resemble dementia. The results of an evaluation may lead to:

• Treating the underlying disease or health condition
• Managing comorbid conditions and medications more effectively and appropriately for the diagnosis
• Averting or addressing potential safety issues
• Allowing the patient to create or update advance directives and plan long-term care
• Ensuring the patient has support services and a care network to help with medical, legal, and financial concerns
• Working with the patient and their caregiver to develop strategies to improve quality of life, modify the patient’s lifestyle, make home safety modifications, and manage emotions related to the dementia diagnosis
• Referring the patient to a geriatrician, neurologist, geriatric psychiatrist, neuropsychologist, geriatric social worker, geriatric counselor, mental health counselor, or substance abuse professional for a more specific diagnosis or help with care management
• Ensuring the caregiver receives appropriate information, referrals, and support for coping with a dementia diagnosis, managing stress, and preparing for expected changes as well as making the best use of intact abilities
• Encouraging participation in clinical research, including clinical trials and studies

Learn more at Alzheimers.gov/clinical-trials and Talking With Your Patients About Alzheimer’s and Related Dementias Clinical Trials.

When is assessment indicated?

In its 2020 review and recommendation regarding routine screening for cognitive impairment in adults 65 years old and older, the U.S. Preventive Services Task Force noted that “although there is insufficient evidence to recommend for or against screening for cognitive impairment, there may be important reasons to identify cognitive impairment early. Clinicians should remain alert to early signs or symptoms of cognitive impairment (e.g., problems with memory or language) and evaluate the individual as appropriate.”⁽¹⁷⁾

Other risk factors that could indicate the need for dementia screening include: history of type 2 diabetes, stroke, depression, trouble managing money or medications, and being older than 80.⁽¹⁸⁾ Tools such as the Dementia Screening Indicator can help guide clinician decisions about when it may be appropriate to screen for cognitive impairment in the primary care setting.⁽¹⁸⁾

How can physicians and staff find time for assessment?

Trained staff need only 10 minutes or less to initially assess a patient for cognitive impairment. While results alone are insufficient to diagnose dementia, they are an important first step. The AD8, QDRS, and Mini-Cog are among many possible tools and some can be filled out by the person or the caregiver while in the waiting room.

Disclaimer: NIA does not endorse any specific cognitive assessment tools. The selection of an assessment tool depends on a variety of factors, including the setting, target population age and demographics, language, and expertise of the administrator. Research is underway to create and validate new tools for cognitive assessment in primary care settings. For more information, visit Cognitive Assessment Considerations: Understanding the Evidence.

How to assess for cognitive impairment

Assessment for cognitive impairment can be performed at any visit but is a required component of the Medicare Annual Wellness Visit.^(8, 19) Coverage for yearly wellness visits, and importantly, for follow-up visits for cognitive assessment and care plan services, is available to patients with Medicare Part B coverage.

Visit the Centers for Medicare & Medicaid Services (CMS) for more information on cognitive assessment and care plan services (code 99483), including what it covers and how to bill for it. CMS also created a related educational video for health care providers. The Alzheimer’s Association also offers information on cognitive assessment and care planning services.

Positive results from a brief assessment warrant further evaluation. A combination of neuropsychological evaluation, including self- and informant-reports from a person who has frequent contact with the person being evaluated, such as a spouse or other care provider, is the best way to assess cognitive impairment more fully.⁽²⁰⁾

A primary care provider may conduct an evaluation or refer to a specialist, such as a geriatrician, neurologist, geriatric psychiatrist, or neuropsychologist. If available, a local memory disorders clinic or an NIA-funded Alzheimer’s Disease Research Center may also accept referrals.

Genetic testing, neuroimaging, and biomarker testing have been recommended for limited clinical uses.^(2, 21) These tests are primarily conducted in research settings and may require consultation with the medical provider, a counselor, and the family and caregivers as there are complex ethical, legal, and social implications that should be considered. In addition, some new Alzheimer’s medications may require or warrant the confirmation of beta-amyloid plaques before prescribing, as well as brain imaging during treatment to evaluate for amyloid-related imaging abnormalities (ARIA).

Interviews to assess memory, behavior, mood, and functional status of the patient are best conducted without family members or companions present who may prompt the person’s responses. However, family members or close companions can also be good sources of information. It can be beneficial to speak with them while the patient is in the room, as well as privately to allow for a more candid discussion. Per HIPAA regulations, the patient should give permission in advance. Brief, easy-to-administer tools, such as the Short IQCODE (PDF, 1.9M), the AD8, or the QDRS for the caregiver are available.

Note that people who are only mildly impaired may be adept at covering up their cognitive decline and reluctant to address the problem. In some cases, patients may not have insight into their cognitive and functional problems due to the nature of their illness.

Additional resources are available to help health care teams in their detection of cognitive impairment and support of patients. For example, the American Academy of Family Physicians developed a Cognitive Care Kit, and the Gerontological Society of America developed the GSA KAER Toolkit for Primary Care Teams.

For more information on cognitive assessment tools, and other resources for health professionals, visit Alzheimer’s and Related Dementias Resources for Professionals.

What to do after assessment

After assessment for cognitive impairment is complete, take time to reflect on your relationship with the person to determine the best way to deliver the results.

Some people may prefer a cautious, reserved explanation. Other patients may prefer more precise language and appreciate when specific words, such as “Alzheimer’s disease,” are referenced.

The American College of Physicians Foundation and Alzheimer’s Association have produced an 11-minute video, Disclosing an Alzheimer’s Diagnosis, that may be helpful. Written materials can also be helpful: NIA’s Alzheimer’s and related Dementias Education and Referral Center has free tools and publications you can give to your patients, including Next Steps After an Alzheimer’s Diagnosis. Local resources can also be found using the Eldercare Locator.

Communicating with older patients

If possible, schedule additional time for the appointment or a follow-up, so that you can listen and respond to the patient’s and caregiver’s concerns. Ask the patient if there is a family member or friend who can help with medical, legal, and financial concerns going forward. Suggest making these arrangements as early as possible and ensure that the patient has given you formal authorization to include the caregiver in the conversation about your patient’s care. Keep that person’s name and contact information in your notes for future reference.

Informing family members or others that the patient may have Alzheimer’s, or any cognitive impairment, may be done in a telephone conference or group meeting, which should be arranged with the consent of the patient. It is the patient’s choice on how, whether, and with whom they want to share this information. Let everyone know that you will continue to be available for care, information, guidance, and support. And provide them with resources, such as the 24/7 helpline, in writing. Make them aware that there are support groups and other ways to get help.

Consider how your practice can coordinate and integrate care for the patient and caregiver across the many specialists and services that will be involved. Nonprofit support and community organizations can provide information about planning, social services, and care.

Learn more in Caring for Older Patients With Cognitive Impairment.

Communicating with caregivers

All caregivers face challenges, but these challenges are compounded for people caring for patients with Alzheimer’s or other forms of cognitive impairment. Here are some approaches that can be especially useful when communicating with caregivers:

• Explain that much can be done to improve the patient’s quality of life. Measures such as modifications in daily routine and medications may help. If the patient is in the later stages of dementia, consider bringing in a palliative care consultant to help with symptom management.
• Provide information about the consumer resources and services available from local organizations, as well as support groups.
• Encourage caregivers to get regular respite, especially when patients require constant attention. Ask if the caregiver, who is at considerable risk for stress-related disorders, is receiving adequate support. Encourage the caregiver to speak with their own health care provider. They may have trouble recognizing their own needs when they are so focused on their loved one; assure them that it is crucial to take care of themselves in order to best support their loved one.

Points to remember

• People should be assessed for cognitive impairment if:
  • The individual, family members, or others express concerns about changes in the person’s memory, thinking, or behavior
  • As the health care provider, you observe problems/changes in the patient’s memory, thinking, or behavior
• Brief assessments are available and can be used in an office visit.
• Assessment for cognitive impairment is a required component of the Medicare Annual Wellness Visit.
• People, particularly those who express a concern, likely want to know what the underlying problem is. It is important to emphasize that, no matter what the diagnosis is, there are options for support and care for the person and their caregivers.
• It’s important to talk with the patient and caregiver about potential challenges and how to cope with their results.

To learn more, please visit https://www.nia.nih.gov/health/health-care-professionals-information/assessing-cognitive-impairment-older-patients.

Dietary supplements can be beneficial at any age, but they can also have unwanted side effects, such as unsafe prescription drug interactions. They could also not work at all.

It’s important to understand the supplements you are taking and why you are taking them. Talk with your doctor if you are considering taking a supplement.

What is a dietary supplement?

Dietary supplements are substances you might use to add nutrients to your diet or to lower your risk of health problems such as osteoporosis or arthritis. Dietary supplements come in the form of pills, capsules, powders, gel capsules and tablets, extracts, or liquids. They might contain vitamins, minerals, fiber, amino acids, herbs or other plants, or enzymes. Sometimes, the ingredients in dietary supplements are added to foods and drinks. A doctor’s prescription is not needed to buy dietary supplements.

Should I take a dietary supplement?

Eating a variety of healthy foods is the best way to get the nutrients you need. However, some people may not get enough vitamins and minerals from their daily diet. When that’s the case, their doctors may recommend a dietary supplement to provide missing nutrients.

If you are thinking about using dietary supplements:

• Learn. Find out as much as you can about any dietary supplement you might take. Talk with your doctor, pharmacist, or a registered dietitian. A supplement that seemed to help your neighbor might not work for you. If you are reading fact sheets or checking websites, be aware of the source of the information. Could the writer or group profit from the sale of a particular supplement? Read more about choosing reliable health information websites.
• Remember. Just because something is said to be “natural” doesn’t mean it is safe or good for you. It could have side effects. It might make a medicine your doctor prescribed for you either weaker or stronger. It could also be harmful to you if you have certain medical conditions.
• Tell your doctor. Before deciding to start taking a dietary supplement to treat any health condition, check with your doctor. Do not take a supplement to try to diagnose or treat any health condition without first checking with your doctor. Learn how medications can interact with dietary supplements. For more information, visit the National Center for Complementary and Integrative Health.
• Buy wisely. Choose brands that your doctor, dietitian, or pharmacist recommend. Don’t buy dietary supplements with ingredients you don’t need. Don’t assume that more is better — it can actually be harmful to take too many supplements or those with a very high concentration of a nutrient. It is possible to waste money on unneeded supplements.
• Check the science. Make sure any claim about a dietary supplement is based on scientific proof. Look for the United States Pharmacopeia (USP) verified mark. USP verifies the identity, quality, strength, and purity of supplements. Information on some dietary supplements is available on MedlinePlus, but it’s important to note that most supplements listed have limited evidence of any benefit. If something sounds too good to be true, it probably is.
• Be a savvy consumer. Some advertisements for dietary supplements in magazines, online, or on TV promise that some of these products will make you feel better, keep you from getting sick, or even help you live longer. It’s important to know that often, there is little, if any, science supporting these claims.

Dietary supplements for older adults

People over age 50 may need more of some vitamins and minerals than younger adults do. Your doctor or a dietitian can tell you whether you need to change your diet or take a vitamin or mineral supplement to get enough of these:

• Calcium: Calcium works with vitamin D to keep bones strong at all ages. Bone loss can lead to fractures in both older women and men. Calcium is found in milk and milk products (fat-free or low-fat is best), canned fish with soft bones, dark-green leafy vegetables like kale, and foods with calcium added, such as breakfast cereals.
• Vitamin D: Most people in the United States consume less than recommended amounts of vitamin D. Talk with your doctor about adding vitamin D-fortified milk and milk products, vitamin D-fortified cereals, and fatty fish to your diet, or using a vitamin D supplement.
• Vitamin B6: This vitamin is needed to form red blood cells. It is found in potatoes, bananas, chicken breasts, and fortified cereals.
• Vitamin B12: This helps keep your red blood cells and nerves healthy. While older adults need just as much vitamin B12 as other adults, some have trouble absorbing the vitamin naturally found in food. If you have this problem, your doctor may recommend that you eat foods like fortified cereals with this vitamin added, or take a B12 supplement. Strict vegetarians and vegans are at greater risk of developing vitamin B12 deficiency because natural food sources of vitamin B12 are limited to animal foods. Talk with your doctor about whether taking a B12 supplement is right for you.

What are antioxidants?

You might hear about antioxidants in the news. These are natural substances in food that might help protect you from some diseases. Here are some common antioxidants that you should be sure to include in your diet:

• Beta-carotene: Found in fruits and vegetables that are either dark green or dark orange
• Selenium: Found in seafood, liver, meat, and grains
• Vitamin C: Found in citrus fruits, peppers, tomatoes, and berries
• Vitamin E: Found in wheat germ, nuts, and sesame seeds; and canola, olive, and peanut oils

Currently, research results suggest that large doses of supplements with antioxidants will not prevent chronic diseases such as heart disease or diabetes. In fact, some studies have shown that taking large doses of some antioxidants could be harmful. Again, it is best to check with your doctor before taking a dietary supplement.

Herbal supplements and older adults

Herbal supplements are dietary supplements that come from plants. These types of supplements are taken by mouth, whether it’s by a capsule, tablet, powder, or liquid.

A few that you may have heard of are ginkgo biloba, ginseng, echinacea, and black cohosh. Researchers are looking at using herbal supplements to prevent or treat some health problems, but it’s too early to know if these are both safe and useful. Previous studies of certain herbal supplements have not shown any benefits.

It’s important to know that just because a supplement is natural, or comes from plants, that doesn’t necessarily mean it’s safe.

Are dietary supplements safe?

The U.S. Food and Drug Administration (FDA) checks prescription medicines, such as antibiotics or blood pressure drugs, to make sure they are safe and do what they promise. The same is true for over-the-counter drugs such as pain and cold medicines. However, the FDA does not have authority over dietary supplements, which do not have to be approved by this agency for safety or efficacy before being sold to the public.

The federal government does not regularly test what is in dietary supplements, and companies are not required to share information about the safety of these products with the FDA before they sell them. So, just because a dietary supplement is on a store shelf, that does not mean it is safe, does what the label says it will, or contains what the label states.

If the FDA receives reports of possible problems with a supplement, it will issue warnings about the product. The FDA may also take supplements that are found to be unsafe off the market.

The Federal Trade Commission investigates reports of ads that might misrepresent what dietary supplements do. A few private groups, such as the U.S. Pharmacopeia, NSF International, ConsumerLab.com, and the Natural Products Association, have their own “seals of approval” for dietary supplements. To earn such a seal, products must be made by following good manufacturing procedures, must contain what is listed on the label, and must not have harmful levels of ingredients that don’t belong there, such as lead.

Whether you take dietary supplements or not, it’s still important to follow a healthy lifestyle. Try sticking to a healthy diet, being physically active, keeping your mind active, not smoking, and seeing your doctor regularly.

To learn more, please visit https://www.nia.nih.gov/health/vitamins-and-supplements/dietary-supplements-older-adults.

Alzheimer’s disease often affects a person’s sleeping habits. People with Alzheimer’s may experience the following sleep problems:

• Sleeping a lot or not enough
• Waking up many times during the night
• Napping a lot during the day
• Restlessness, agitation, irritability, and confusion as daylight begins to fade, known as sundowning

Here are some tips that may help caregivers ease sleep problems in people with Alzheimer’s: 

• Help the person get exercise each day.
• Limit naps and dozing late in the day.
• Plan activities that use more energy early in the day. For example, try bathing in the morning or having the largest meal in the middle of the day.
• Set a quiet, peaceful mood in the evening to help the person relax. Keep the lights low, try to reduce noise levels, and play soothing music if the person enjoys it.
• Follow a regular schedule by going to sleep and getting up at the same time each day, even on weekends or when traveling.
• Develop a relaxing bedtime routine with lowered lights, cool temperature, and no electronic screens.
• Avoid alcohol and caffeine.
• Use nightlights in the bedroom, hall, and bathroom.

Getting Help with Sleep Problems

If sleep problems continue to be a challenge, talk with a health care provider. They may be able to identify possible causes and suggest solutions. For example, a person with Alzheimer’s may have a medical condition or take a medication that causes sleep problems. In other cases, Alzheimer’s itself may be causing changes to the brain that disrupts sleep. The health care provider may recommend medication or nonmedication strategies to help the person sleep well.

To learn more, please visit https://www.nia.nih.gov/health/sleep/managing-sleep-problems-alzheimers-disease.

Many factors influence healthy aging. Some of these, such as genetics, are not in our control. Others — like exercise, a healthy diet, going to the doctor regularly, and taking care of our mental health — are within our reach. Research supported by NIA and others has identified actions you can take to help manage your health, live as independently as possible, and maintain your quality of life as you age. Read on to learn more about the research and the steps you can take to promote healthy aging.

Taking care of your physical health

While scientists continue to actively research how to slow or prevent age-related declines in physical health, they’ve already discovered multiple ways to improve the chances of maintaining optimal health later in life. Taking care of your physical health involves staying active, making healthy food choices, getting enough sleep, limiting your alcohol intake, and proactively managing your health care. Small changes in each of these areas can go a long way to support healthy aging.

Get moving: Exercise and physical activity

Whether you love it or hate it, physical activity is a cornerstone of healthy aging. Scientific evidence suggests that people who exercise regularly not only live longer, but also may live better — meaning they enjoy more years of life without pain or disability.

A study of adults 40 and older found that taking 8,000 steps or more per day, compared to only taking 4,000 steps, was associated with a 51% lower risk of death from all causes. You can increase the number of steps you get each day by doing activities that keep your body moving, such as gardening, walking the dog, and taking the stairs instead of the elevator.

Although it has many other benefits, exercise is an essential tool for maintaining a healthy weight. Adults with obesity have an increased risk of death, disability, and many diseases such as type 2 diabetes and high blood pressure. However, thinner is not always healthier either. Being or becoming too thin as an older adult can weaken your immune system, increase the risk of bone fracture, and in some cases may be a symptom of disease. Both obesity and underweight conditions can lead to loss of muscle mass, which may cause a person to feel weak and easily worn out.

As people age, muscle function often declines. Older adults may not have the energy to do everyday activities and can lose their independence. However, exercise can help older adults maintain muscle mass as they age. In a 2019 investigation of data from NIA’s Baltimore Longitudinal Study of Aging, researchers found that moderate to vigorous physical activity is strongly associated with muscle function, regardless of age. This suggests that exercise may be able to prevent age-related decline in muscle function.

In addition to helping older adults live better, maintaining muscle mass can help them live longer. In another study, researchers found that in adults older than 55, muscle mass was a better predictor of longevity than was weight or body mass index (BMI).

What can you do?

Although many studies focus on the effects of physical activity on weight and BMI, research has found that even if you’re not losing weight, exercise can still help you live longer and better. There are many ways to get started. Try being physically active in short spurts throughout the day or setting aside specific times each week to exercise. Many activities, such as brisk walking or yoga, are free or low cost and do not require special equipment. As you become more active, you will start feeling energized and refreshed after exercising instead of exhausted. The key is to find ways to get motivated and get moving.

Healthy eating: Make smart food choices

Making smart food choices can help protect you from certain health problems as you age and may even help improve brain function. As with exercise, eating well is not just about your weight. With so many different diets out there, choosing what to eat can be confusing. The 2020-2025 Dietary Guidelines for Americans provide healthy eating recommendations for each stage of life. The Dietary Guidelines suggest an eating pattern with lots of fresh fruits and vegetables, whole grains, healthy fats, and lean proteins.

Much of the research shows that the Mediterranean-style eating pattern, which includes fresh produce, whole grains, and healthy fats, but less dairy and more fish than a traditional American diet, may have a positive impact on health. A 2021 study analyzing the eating patterns of more than 21,000 participants found that people closely following the Mediterranean-style pattern had a significantly lower risk of sudden cardiac death.

A low-salt diet called Dietary Approaches to Stop Hypertension (DASH) has also been shown to deliver significant health benefits. Studies testing the DASH diet found that it lowers blood pressure, helps people lose weight, and reduces the risk of type 2 diabetes and heart disease.

Yet another eating pattern that may support healthy aging is the MIND diet, which combines a Mediterranean-style eating pattern with DASH. Researchers have found that people who closely follow the MIND diet have better overall cognition — the ability to clearly think, learn, and remember — compared to those with other eating styles.

What can you do?

Try starting with small changes by adopting one or two aspects of the Mediterranean-style eating pattern or MIND diet. Several studies have shown that incorporating even a part of these eating patterns, such as more fish or more leafy greens, into your daily eating habits can improve health outcomes. One study of 182 older adults with frequent migraines found that a diet lower in vegetable oil and higher in fatty fish could reduce migraine headaches. Another study that followed almost 1,000 older adults over five years found that consumption of green leafy vegetables was significantly associated with slower cognitive decline.

Even if you haven’t thought much about healthy eating until recently, changing your diet now can still improve your well-being as an older adult. If you are concerned about what you eat, talk with your doctor about ways you can make better food choices.

Getting a good night’s sleep

Getting enough sleep helps you stay healthy and alert. Even though older adults need the same seven to nine hours of sleep as all adults, they often don’t get enough. Feeling sick or being in pain can make it harder to sleep, and some medicines can keep you awake. Not getting enough quality sleep can make a person irritable, depressed, forgetful, and more likely to have falls or other accidents.

Sleep quality matters for memory and mood. In one study of adults older than 65, researchers found that those who had poor sleep quality had a harder time problem-solving and concentrating than those who got good quality sleep. Another study, which looked at data from nearly 8,000 people, showed that those in their 50s and 60s who got six hours of sleep or less a night were at a higher risk of developing dementia later in life. This may be because inadequate sleep is associated with the buildup of beta-amyloid, a protein involved in Alzheimer’s disease. Poor sleep may also worsen depression symptoms in older adults. Emerging evidence suggests that older adults who were diagnosed with depression in the past, and do not get quality sleep, may be more likely to experience their depression symptoms again.

More generally, a 2021 study found that older adults who did not sleep well and napped often were at greater risk of dying within the next five years. Conversely, getting good sleep is associated with lower rates of insulin resistance, heart disease, and obesity. Sleep can also improve your creativity and decision-making skills, and even your blood sugar levels.

What can you do?

There are many things you can do to help you sleep better, such as following a regular sleep schedule. Try to fall asleep and get up at the same time each day. Avoid napping late in the day, as this may keep you awake at night. Exercise can help you sleep better, too, if it isn’t too close to bedtime. Research suggests that behavioral interventions, such as mindfulness meditation, can also improve sleep quality.

Quit smoking

It doesn’t matter how old you are or how long you’ve been smoking, research confirms that even if you’re 60 or older and have been smoking for decades, quitting will improve your health. Quitting smoking at any age will:

• Lower your risk of cancer, heart attack, stroke, and lung disease
• Improve your blood circulation
• Improve your sense of taste and smell
• Increase your ability to exercise
• Set a healthy example for others

One study found that among men 55 to 74 years old and women 60 to 74 years old, current smokers were three times more likely to die within the six-year follow-up period than those who had never smoked.

What can you do?

If you smoke, quit. Quitting smoking is good for your health and may add years to your life. One study of nearly 200,000 people demonstrated that older adults who quit smoking between the ages of 45 and 54 lived about six years longer compared to those who continued to smoke. Adults who quit between the ages of 55 to 64 lived about four years longer. It is never too late to stop smoking and reap the benefits of breathing easier, having more energy, saving money, and improving your health.

Alcohol and other substances

Like all adults, older adults should avoid or limit alcohol consumption. In fact, aging can lead to social and physical changes that make older adults more susceptible to alcohol misuse and abuse and more vulnerable to the consequences of alcohol. Alcohol dependence or heavy drinking affects every organ in the body, including the brain.

A comprehensive study from the National Institute on Alcohol Abuse and Alcoholism shows that alcohol consumption among older adults, especially women, is on the rise. The researchers also found evidence that certain brain regions show signs of premature aging in alcohol-dependent men and women. In addition, heavy drinking for extended periods of time in older adults may contribute to poor heart health, as shown in this 2016 study. These studies suggest that stopping or limiting the use of alcohol could improve heart health and prevent the accelerated aging seen with heavy alcohol use.

In addition to being cautious with alcohol, older adults and their caregivers should be aware of other substances that can be misused or abused. Because older adults are commonly prescribed opioids for pain and benzodiazepines for anxiety or trouble sleeping, they may be at risk for misuse and dependence on these substances. One study of adults age 50 and older showed that misuse of prescription opioids or benzodiazepines is associated with thoughts of suicide.

What can you do?

Learn about the current U.S. guidelines for drinking and when to avoid alcohol altogether. It’s important to be aware of how much you are drinking and the harm that drinking can cause. If you or a loved one needs help with substance abuse or alcohol use, talk with your doctor or a mental health professional. You can also try finding a support group for older adults with substance or alcohol abuse issues.

Learn about substance use in older adults and get tips on how to stop drinking alcohol or drink less alcohol.

Go to the doctor regularly

Going to the doctor for regular health screenings is essential for healthy aging. A 2021 study found that getting regular check-ups helps doctors catch chronic diseases early and can help patients reduce risk factors for disease, such as high blood pressure and cholesterol levels. People who went to the doctor regularly also reported improved quality of life and feelings of wellness.

In recent years, scientists have developed and improved upon laboratory, imaging, and similar biological tests that help uncover and monitor signs of age-related disease. Harmful changes in the cells and molecules of your body may occur years before you start to experience any symptoms of disease. Tests that detect these changes can help medical professionals diagnose and treat disease early, improving health outcomes.

What can you do?

Visit the doctor at least yearly and possibly more depending on your health. You cannot reap the benefits of medical advancements without regular trips to the doctor for physical exams and other tests. Regular screenings can uncover diseases and conditions you may not yet be aware of, such as diabetes, cancer, and cardiovascular disease. If you only seek medical attention when you’re experiencing symptoms, you may lose the chance of having your doctor catch a disease in its earliest stages, when it would be most treatable. Regular check-ups can help ensure you could start treatment months or years earlier than would have been possible otherwise.

Taking care of your mental health

Mental health, or mental wellness, is essential to your overall health and quality of life. It affects how we think, feel, act, make choices, and relate to others. Managing social isolation, loneliness, stress, depression, and mood through medical and self-care is key to healthy aging.

Social isolation and loneliness

As people age, changes such as hearing and vision loss, memory loss, disability, trouble getting around, and the loss of family and friends can make it difficult to maintain social connections. This makes older adults more likely to be socially isolated or to feel lonely. Although they sound similar, social isolation and loneliness are different. Loneliness is the distressing feeling of being alone or separated, while social isolation is the lack of social contacts and having few people to interact with regularly.

Several recent studies show that older adults who are socially isolated or feel lonely are at higher risk for heart disease, depression, and cognitive decline. A 2021 study of more than 11,000 adults older than age 70 found that loneliness was associated with a greater risk of heart disease. Another recent study found that socially isolated older adults experienced more chronic lung conditions and depressive symptoms compared to older adults with social support.

Feeling lonely can also impact memory. A study of more than 8,000 adults older than 65 found that loneliness was linked to faster cognitive decline.

Research also shows that being socially active can benefit older adults. A study of more than 3,000 older adults found that making new social contacts was associated with improved self-reported physical and psychological well-being. Being social may also help you reach your exercise goals. A 2019 study found that older adults who had regular contact with friends and family were more physically active than those who did not.

What can you do?

Staying connected with others may help boost your mood and improve your overall well-being. Stay in touch with family and friends in person or over the phone. Scheduling time each day to connect with others can help you maintain connections. Meet new people by taking a class to learn something new or hone a skill you already have.

Stress

Stress is a natural part of life and comes in many forms. Sometimes stress arises from difficult events or circumstances. Positive changes, like the birth of a grandchild or a promotion, can cause stress too. Research shows that constant stress can change the brain, affect memory, and increase the risk of developing Alzheimer’s or related dementias.

Older adults are at particular risk for stress and stress-related problems. A recent study examined how levels of the stress hormone cortisol change over time. Researchers have found that cortisol levels in a person’s body increase steadily after middle-age, and that this age-related increase in stress may drive changes in the brain. A meta-analysis funded by the National Institute of Mental Health supports the notion that stress and anxiety rewire the brain in ways that can impact memory, decision-making, and mood.

Finding ways to lower stress and increase emotional stability may support healthy aging. In an analysis of data from the Baltimore Longitudinal Study of Aging, scientists followed 2,000 participants for more than five decades, monitoring their mood and health. The data reveal that individuals who were emotionally stable lived on average three years longer than those who had a tendency toward being in a negative or anxious emotional state. Long-term stress also may contribute to or worsen a range of health problems, including digestive disorders, headaches, and sleep disorders.

What can you do?

You can help manage stress with meditation techniques, physical activity, and by participating in activities you enjoy. Keeping a journal may also help you identify and challenge negative and unhelpful thoughts. Reach out to friends and family who can help you cope in a positive way.

Depression and overall mood

Although depression is common in older adults, it can be difficult to recognize. For some older adults with depression, sadness is not their main symptom. Instead, they might feel numb or uninterested in activities and may not be as willing to talk about their feelings. Depression not only affects mental health, but also physical health. A review article funded by the National Heart, Lung, and Blood Institute summarizes hundreds of studies from around the world showing that depression increases risk of heart disease and metabolic disorders. Research has also shown that recurrent depression is a risk factor for dementia. In a study of more than 1,000 older adults, scientists found a relationship between the number of depressive episodes and increased risk of developing Alzheimer’s.

Although different than depression, which is a serious medical disorder, mood changes can also influence aging. A 2020 longitudinal study demonstrated a link between positive mood and better cognitive control. Further studies are necessary to determine whether changes that improve mood could improve cognition. The way you think about aging can also make a difference. Research shows that whether you hold negative or positive views about aging may impact health as you age. Negative beliefs about aging may increase undesirable health outcomes, Alzheimer’s disease biomarkers, and cellular aging. Meanwhile, positive beliefs about aging may decrease the risk of developing dementia and obesity.

What can you do?

Depression, even when severe, can be treated. As soon as you begin noticing signs, it’s important to get evaluated by a health care professional. In addition to deep sadness or numbness, lack of sleep and loss of appetite are also common symptoms of depression in older adults. If you think you or a loved one may have depression, start by making an appointment to see your doctor or health care provider. If you are thinking of harming yourself, get help immediately — call or text 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.

Leisure activities and hobbies

Your favorite activities are not only fun — they may also be good for your health. Research shows that people who participate in hobbies and social and leisure activities may be at lower risk for some health problems. For example, one study found that participation in a community choir program for older adults reduced loneliness and increased interest in life. Another study showed that older adults who spent at least an hour reading or engaged in other hobbies had a decreased risk of dementia compared to those who spent less than 30 minutes a day on hobbies.

Research on music, theater, dance, creative writing, and other participatory arts shows promise for improving older adults’ quality of life and well-being, from better cognitive function, memory, and self-esteem to reduced stress and increased social interaction. Even hobbies as simple as taking care of a pet can improve your health. According to a 2020 study, pet ownership (or regular contact with pets) was associated with better cognitive function, and in some cases, better physical function.

What can you do?

Look for opportunities to participate in activities. Get out and about by going to a sporting event, trying a new restaurant, or visiting a museum. Learn how to cook or play a musical instrument. Consider volunteering at a school, library, or hospital to become more active in your community.

Taking care of your cognitive health

Cognition — the ability to clearly think, learn, and remember — often changes as we age. Although some people develop Alzheimer’s or other types of dementia, many older adults experience more modest changes in memory and thinking. Research shows that healthy eating, staying active, and learning new skills may help keep older adults cognitively healthy.

How different factors affect cognitive health

If you think your daily choices don’t make a difference, data from an NIH study with 3,000 participants show otherwise. Researchers scored participants on five healthy lifestyle factors, all of which have important health benefits:

• At least 150 minutes per week of moderate- to vigorous-intensity physical activity
• Not smoking
• Not drinking heavily
• A high-quality, Mediterranean-style diet
• Engagement in mentally stimulating activities, such as reading, writing letters, and playing games

The findings show that making these small, daily changes can add up to significant health benefits. Those who followed at least four of these healthy lifestyle behaviors had a 60% lower risk of developing Alzheimer’s. Even practicing just two or three activities lowered the risk by 37%. While results from observational studies such as this one cannot prove cause and effect, they point to how a combination of modifiable behaviors may mitigate Alzheimer’s risk and identify promising avenues to be tested in clinical trials.

New clinical trials are also testing the benefits of tightly controlling blood pressure on healthy aging. These trials are based on a 2019 study, with data supporting the idea that intensive blood pressure control may slow age-related brain damage and even mild cognitive impairment, which can increase the risk for Alzheimer’s or a related dementia.

Researchers continue work to understand how we might prevent Alzheimer’s and other forms of age-related cognitive decline. NIA is currently funding more than 350 active clinical trials on Alzheimer’s and related dementias, 100 of which use nondrug interventions, such as exercise, diet, cognitive training, sleep, or combination therapies.

How cognitive training affects health outcomes

Many brain training programs are marketed to the public to improve cognition. Although some of these computer or smartphone-based interventions show promise, so far there is no conclusive evidence that these applications are beneficial.

But there is some evidence that exercising your brain by learning a new skill can improve memory function. A study of adults 60 and older showed that sustained engagement in cognitively demanding, novel activity enhanced memory function. In particular, the new skills learned in this study were 1) learning how to use computer software to edit photos and 2) learning how to quilt. Learning a new game, instrument, craft, or other skill can be fun and may have the added benefit of staving off memory loss as you age.

Taking care of your physical, mental, and cognitive health is important for healthy aging. Even making small changes in your daily life can help you live longer and better. In general, you can support your physical health by staying active, eating and sleeping well, and going to the doctor regularly. Take care of your mental health by interacting with family and friends, trying to stay positive, and participating in activities you enjoy. Taking steps to achieve better physical and mental health may reduce your risk for Alzheimer’s and related dementias as you age.

Next steps

There is still a lot to learn, though, about how people age and what habits support healthy aging. Scientists are exploring these questions with studies that look at physical, mental, and cognitive health. You can be a part of scientific progress by joining a clinical trial or research study in person or online. All types of volunteers are needed, including caregivers, older adults with medical conditions, and those who are healthy.

To explore all trials funded by NIH, visit ClinicalTrials.gov. To find Alzheimer’s and related dementias research studies, visit the Alzheimers.gov Clinical Trials Finder. Every treatment available today is due to people like you who choose to participate in clinical research.

To learn more, please visit https://www.nia.nih.gov/health/healthy-aging/what-do-we-know-about-healthy-aging.

Seneca Place is excited to share Mr. Ulery’s Success Story!

Mr. Ulery admitted to our community for short-term rehab due to decline in activities of daily living, functional mobility, and strength. He initially required extensive assistance with tasks and was very unsteady on his feet not allowing him to safely ambulate. With the assist of PT and OT services, Mr. Ulery has improved to setup and supervision levels for all functional tasks! He is ambulating 175 ft with use of a walker. He is ready to start the next step of his recovery while returning home. During his stay, he shared that he liked all the Care Team members. His advice to other people receiving therapy is to “keep fighting” and “When you feel like you don’t want to go to therapy, just go! It will be better in the end.” Congratulations to Mr. Ulery and his Care Team on their success!

Have you ever felt dizzy, lightheaded, or as if the room were spinning around you? These can be troublesome sensations. If the feeling happens often, it could be a sign of a balance problem.

Many older adults experience problems with balance and dizziness. Problems can be caused by certain medications, balance disorders, or other medical conditions. Balance problems are one reason older people fall. Maintaining good balance as you age and learning about fall prevention can help you get around, stay independent, and carry out daily activities.

Causes of balance problems

People are more likely to have problems with balance as they grow older. In some cases, you can help reduce your risk for certain balance problems, but problems often can start suddenly and without obvious cause.

Balance problems can be caused by certain medications or medical conditions. The list below covers some common causes of balance problems.

• Medications. Check with your doctor if you notice balance problems while taking certain medications. Ask if other medications can be used instead, if the dosage can be safely reduced, or if there are other ways to reduce unwanted side effects.
• Inner ear problems. A part of the inner ear called the labyrinth is responsible for balance. When the labyrinth becomes inflamed, a condition called labyrinthitis occurs, causing vertigo and imbalance. Certain ear diseases and infections can lead to labyrinthitis.
• Alcohol. Alcohol in the blood can also cause dizziness and balance problems by affecting how the inner ear works.
• Other medical conditions. Certain conditions, such as diabetes, heart disease, stroke, or problems with your vision, thyroid, nerves, or blood vessels can cause dizziness and other balance problems.

Visit the NIH National Institute on Deafness and Other Communication Disorders website for more information on specific balance disorders.

Symptoms of balance disorders

If you have a balance disorder, you might experience symptoms such as:

• Dizziness or vertigo (a spinning sensation)
• Falling or feeling as if you are going to fall
• Staggering when you try to walk
• Lightheadedness, faintness, or a floating sensation
• Blurred vision
• Confusion or disorientation

Other symptoms might include nausea and vomiting; diarrhea; changes in heart rate and blood pressure and feelings of fear, anxiety, or panic. Symptoms may come and go over short periods or last for a long time and can lead to fatigue and depression.

Treatments for balance problems and disorders

Exercises that involve moving the head and body in certain ways can help treat some balance disorders. Patient-specific exercises are developed by a physical therapist or other professional who understands balance and its relationship with other systems in the body.

Balance problems due to high blood pressure may be managed by eating less salt (sodium), maintaining a healthy weight, and exercising. Balance problems due to low blood pressure may be managed by drinking plenty of fluids such as water; avoiding alcohol; and being cautious regarding your body’s posture and movement, such as never standing up too quickly. Consult with your doctor about making any changes in your diet or activity level.

Coping with a balance disorder

Some people with a balance disorder may not be able to fully relieve their dizziness and will need to find ways to cope with it. A vestibular rehabilitation therapist can help develop an individualized treatment plan.

Chronic balance problems can affect all aspects of your life, including your relationships, work performance, and your ability to carry out daily activities. Support groups provide the opportunity to learn from other people with similar experiences and challenges.

If you have trouble with your balance, talk to your doctor about whether it’s safe to drive, and about ways to lower your risk of falling during daily activities, such as walking up or down stairs, using the bathroom, or exercising. To reduce your risk of injury from dizziness, do not walk in the dark. Avoid high heels and, instead, wear nonskid, rubber-soled, low-heeled shoes. Don’t walk on stairs or floors in socks or in shoes and slippers with smooth soles. If necessary, use a cane or walker. Make changes to add safety features at your home and workplace, such as adding handrails.

To learn more, please visit https://www.nia.nih.gov/health/falls-and-falls-prevention/older-adults-and-balance-problems.

Seneca Place is excited to share resident Ms. Ochsner’s Success Story!

When Ms. Ochsner first arrived at our community, she required assistance with daily living activities and mobility. Through the support of our skilled therapy team, she has made incredible progress—now returning home with family, independent in transfers, ambulating 60 feet, and even climbing 4 steps! She shared, “I liked all my therapists. I felt comfortable with them. They knew when to push and when to give me grace.” Her advice to others in therapy is to “give it your all, and be comical and have fun!” We are so proud of her determination and the amazing teamwork that made this possible!

Many people want the same things as they get older: to stay in their own homes, to maintain independence for as long as possible, and to turn to family and friends for help when needed. Staying in your own home as you get older is called “aging in place.” But many older adults and their families have concerns about safety, getting around, or other daily activities. Living at home as you age requires careful consideration and planning. This article offers suggestions to help you find the help you need to continue to live independently.

Planning ahead for aging in place

The best time to think about how to age in place is before you need a lot of care. Planning ahead allows you to make important decisions while you are still able.

The first step is to think about the kinds of help you need now and might want in the future. You can learn about home-based care and other services in your community and find out what they cost. Planning ahead also gives you time to set up your home to meet your needs as you age.

Another step is to consider any illnesses, such as diabetes or heart disease, that you or your spouse might have. Find out about how the illness could make it hard for someone to get around or take care of themselves in the future. Your health care provider can help answer your questions.

Talk with your family, friends, and other caregivers about what support is needed for you to stay in your home. Be realistic and plan to revisit the decision as your needs change over time.

Support for aging at home

Home-based care includes health, personal, and other support services to help you stay at home and live as independently as possible. In-home services may be short-term — for someone who is recovering from an operation, for example — or long-term, for people who need ongoing help.

In many cases, home-based support is provided at home by informal caregivers, such as family members, friends, and neighbors. It can also be supplemented by formal caregivers and community services.

Help you can receive at home includes:

• Personal care: Help with everyday activities, also called “activities of daily living,” including bathing, dressing, grooming, using the toilet, eating, and moving around — for example, getting out of bed and into a chair
• Household chores: Housecleaning, yard work, grocery shopping, laundry, and similar chores around the house
• Meals: Shopping for food and preparing nutritious meals
• Money management: Tasks such as paying bills and filling out health insurance forms
• Health care: Help with many aspects of health care, including giving medications, caring for wounds, helping with medical equipment, and providing physical therapy
• Transportation: Assistance getting around, such as rides to the doctor’s office or grocery store
• Safety: Home safety features and help in case of a fall or other emergency

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

Making your home safe and accessible

There are a variety of ways to make your surroundings safer and easier to manage so they meet your needs as you age. Go through your home room by room to identify potential problems and safety issues. First, correct any immediate dangers, such as loose stair railings and poor lighting, and then work on other ways to ensure you will be as safe as possible at home.

See the Worksheet: Home Safety Checklist (PDF, 251K) for suggestions to help you identify and remove hazards around the house. Keep in mind that it may not be necessary to make all of the suggested changes. It is important, however, to reevaluate home safety every so often as your needs change.

Are you worried that making changes might be expensive? You may be able to get help paying for repairs and safety updates to your home. Check with your state housing finance agency, social services department, community development groups, or the federal government for financial aid programs and discounts. You can also visit the Eldercare Locator or call 800-677-1116 for help finding resources.

Resources for aging in place

If staying in your home is important to you, you may have concerns about getting around, being safe, and staying connected. Some of these activities become more challenging as you age. The resources below can help you find solutions.

Reach out to people you know. Family, friends, and neighbors are the biggest source of help for many older people. They may be able to drive you to doctor’s appointments, help with errands and chores, or just keep you company. Talk with those close to you about the best way to get what you need. If you are physically able, think about trading services with a friend or neighbor. For example, one could do the grocery shopping, and the other could cook dinner.

Learn about community resources. Your local Area Agency on Aging, local and state offices on aging or social services, or your tribal organization may have lists of services. These organizations will be familiar with resources available in your community and may have tips for accessing them. Health care providers and social workers may also have suggestions. If you belong to a religious community, find out whether it offers services for older adults or ask for guidance from your pastor, rabbi, or other religious leader.

Get help during the day. Support is available if your regular caregiver isn’t available during the day (for example, because they go to work). Some organizations have volunteers who regularly pay short visits to older adults. The volunteer can provide support, assistance, and companionship. Or you might consider an adult day care program, which can offer social activities, exercise, meals, and personal care during the day. Additionally, respite services provide short-term care for an older adult at home when a regular caregiver isn’t available.

Be prepared for a medical emergency. If you have a serious allergy or medical need, talk with your doctor about whether you should get a medical alert ID bracelet or necklace. You might also consider an emergency medical alert system, which responds to medical and other emergencies via an electronic monitor that a person wears. The monitor alerts emergency personnel when a person becomes lost, falls, or needs urgent medical assistance.

Talk to a geriatric care manager. These specially trained professionals can help find resources to make your daily life easier. They will work with you to form a care plan and find services you need. Geriatric care managers can be especially helpful when family members live far apart. Your doctor or other health care provider may be able to recommend a geriatric care manager, or you can contact the Aging Life Care Association for a list of these professionals in your area.

Look into government resources. Federal, state, and local governments offer many resources for older adults and their families and caregivers. A good place to start is the Eldercare Locator, which connects older Americans and their caregivers with trustworthy local support resources. Visit the Eldercare Locator or call 800-677-1116.

How much will it cost to age in place?

An important part of planning is thinking about how you are going to pay for the help you need. Home-based services can be expensive, but they may cost less than moving into a residential facility, such as assisted living or a nursing home.

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 USA.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.

Read more about the options for paying for long-term care.

When it’s time to leave home

Most people prefer to stay in their own home for as long as possible. But there may come a time when it’s no longer safe or comfortable to live alone.

The decision about whether and when an older adult should move from their home is often difficult and emotional. Everyone will have their own reasons for wanting (or not wanting) to take such a step. One person may decide a move is right because they can’t or don’t want to manage the home any longer. For another person, the need for regular, hands-on care motivates a change.

Learn as much as you can about the housing options available as you grow older. Talk with your family about the pros and cons of each option before making a decision.

To learn more, please visit https://www.nia.nih.gov/health/aging-place/aging-place-growing-older-home.

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. Read more about COVID-19 vaccines from the CDC and find out the current vaccine recommendations for older adults.

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 50 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.

Learn more about vaccine safety and side effects.