Health tips for the over 50s

Dr Steve Hambleton is the Federal AMA Vice President and a Brisbane-based GP. Here he shares health insights and advice for those aged 50 and over.

As people move into there 50s and 60s and beyond, health problems will become more numerous and more varied for many of them.
It is important for people as they age to more closely monitor their own health and ensure they get all the important check-ups.
Above all, it is vital that people have a GP they can see regularly and who can provide them with holistic health care and advice, as they grow older.
People should not be afraid to ask questions of their GP, especially in regard to conditions that are known risks for older people.
Here are simple and practical tips.

Men

1. Prostate.
Discuss the prostate issue with your GP. The GP will know your health history and current state of health and will decide whether you need to be tested.
In general, unless you have a family history of prostate cancer the conversation should start when you are about 50. Remember, the jury is still out about the value of the PSA blood test and the digital rectal examination.

Women

1. Breast screening
Every woman should attend for screening mammography from the age of 50 every two years. All women should become familiar with the look and feel of their breasts and any new or unusual change should be reported to your GP. Only five per cent of women are at substantially higher risk of breast cancer than the population. If you have a relative who was diagnosed with breast cancer below the age of 50, then see your GP to discuss the issue further.

2. Pap smear screening
Pap test screening is recommended every two years for women who have ever had sex. The over 50s represents an under-screened group. Eighty five per cent of women in Australia who develop cervical cancer either have not had a Pap test or are significantly under-screened. Remember, women who have female sexual partners are also at risk and need screening.

Everyone

1. Bowel or colo-rectal cancer.
Bowel cancer is common in our society. The screening test is the faecal occult blood test. This is a very simple test that can be done at home and mailed in to the pathology company. Unless you have a family history of colo-rectal cancer, this can begin at age 50 years. It should be repeated every two years

2. Diet
Diet is the key to good health. A mix of different food provides the raw materials that the body needs to stay healthy. Sufficient fibre exercises your insides as well and reduces the risk of diverticular disease of the bowel. The biggest problem with diet is overeating. Remember, ‘energy in’ needs to match the energy ‘going out’. Also, our metabolism slows down as we age, and we need to eat less, or we will inevitably gradually put on weight.

3. Exercise
Exercise keeps your joints lubricated and your muscles strong. Many studies have shown that one hour of exercise three times per week can significantly reduce your risk of heart attack, will burn excess energy and improve your health. Many people enjoy running or jogging, but brisk walking is sufficient for most of us. We need to lift our heart rate and put some colour in our faces. If you are still able to hold a conversation after exercise, you will be well within your safe limits.

3. Weight
Weight goes hand in hand with diet and exercise and is usually the result of an error in one or the other. Our society is growing larger and larger each year. BMI is a good measure to guide us. But for men, if you circumference is greater than 102cm it is time to act. For women, the magic number is 88cm and the limits are tighter if you are Asian or of Aboriginal and Torres Strait Islander extraction.

4. Smoking
Quit. This is the very first thing that smokers can do to improve their health outlook. Smoking is the number one cause of quality life years lost in our modern society. Take some advice - cold turkey is pretty good but there are lots of techniques that can help. Find a reason to quit, make a plan, put your plan into action and stay on track. For more information visit www.quit.org.au

5. Alcohol
Alcohol is the next nasty. For a legal drug, it also robs our society of quality life years. Direct and indirect effects are enormous. Binge drinking among teenagers robs them of their full potential. Society has turned against smoking and now its collective wisdom must turn against alcohol. By limiting consumption to two standard drinks per man or woman reduces your risk of death or injury from alcohol to less than 1 in 100. Every drink above this level continues to increase your lifetime risk of death or injury from alcohol. While many young Australians drink frequently, the highest proportion of daily drinkers in 2007 were those over 60 years old.

6. Family history
- cancer
- heart disease
- stroke
- diabetes

Some diseases do run in families. If you have any of the above, particularly in younger members of your relatives you should talk to your Doctor about your own risks. You can't change your genes but you can avoid the factors that we know contribute to your risk of harm.

7. Blood pressure
Blood pressure check at your GP can give them a clue that early intervention is required. A simple thirty second test could prevent your life from being shortened by stroke or heart attack or renal failure. Home blood pressure monitors are quite accurate these days and you can check your relatives and friends also.
Most adults should have a blood pressure check at least every two years.

8. Screening tests
- blood sugar
- cholesterol
- faecal occult blood testing
- renal function test

Blood tests form a part of good medical management of your health and a thorough health check will include some or all of the above. If they are normal they can be repeated at from two to five year intervals.

9. Skin check
It is very important that we are aware of changes on our skin. We have one of the highest melanoma skin cancer and non-melanoma skin cancer rates in the world in Australia. The risk increases with increased sun exposure. If you have a fair complexion and a tendency to burn then you are at slightly higher risk.

Older people

1. Hearing
Hearing cuts you off from society. Wax build up is the most common cause and is the quickest to fix. Those exposed to loud noises should wear hearing protection. If you are concerned, an audiogram will tell us if a hearing aid will help you.

2. Osteoporosis
A lack of calcium in bones can lead to fractures that are unexpected for the degree of trauma. A broken bone in an older person can set off a viscous cycle, which is hard to stop. We should make sure that our diet contains sufficient calcium – about three serves per day or consider taking calcium supplements. For people who never see the sun, Vitamin D could be the problem.

3. Vision
Glaucoma begins silently robbing sight from the age of 40 and your optometrist or ophthalmologist will always check on it. If you have a family history you are at special risk. Cataracts are now readily dealt with. Macular degeneration cannot be fixed but it can be arrested in some cases. The secret is early diagnosis. Your GP can show you a simple test. If your vision changes, you need to find out why and make sure it is not serious.

4. Falls risk
If we are getting frail and our bones are thinning and our hearing is not so good, a fall can start you on a downward spiral. It is important to fix that rolling up carpet and put more rails on steps and in bathrooms and toilets. An ounce of prevention is not only better than the cure - it might also save your life.

Links for further reading

1. RACGP Red Book
2. RACGP Screening Chart
3. Quit Smoking
4. Australian Guideline to reduce health risks of alcohol