Q&A on healthy aging with Dr. Jatin Dave

Karen Miller | 1/16/2014, 6 a.m.
Dr. Jatin Dave, a geriatrician at Brigham and Women’s Hospital and medical director of geriatrics at Tufts Health Plan, answers ...
Jatin Dave, M.D., M.P.H. Geriatrician, Brigham and Women’s Hospital Medical Director, Geriatrics, Tufts Health Plan

Is an elderly person too old to start an exercise program?

It is never too late to be more physically active and to start an exercise program. Age-related disability is preventable with regular physical activity at any age, including adults in their 80s and 90s. “I am too old to benefit from exercise or physical activity” is a common myth that causes many older adults to stop exercising or not start. Staying active and exercising regularly has both physical and emotional health benefits even in the very old. Being physically active (performing every day activities such as house work, walking and gardening) is just as important as formal exercise programs. Exercise can help prevent or delay many diseases and is effective in treating many chronic conditions.

Why does balance deteriorate with age?

It is unclear whether balance deteriorates universally with aging or frequent falls are caused by an increase in age-related disorders. Good balance requires sensory input (from eyes, inner ear and feet), muscle strength and joint mobility. Therefore, vision problems, such as cataracts or glaucoma, inner ear disorders, or weak muscles and stiff joints due to sedentary lifestyle can lead to balance problems and associated falls.

Is there a point at which the elderly should discontinue screening tests?

Evidence to support routine screening tests after age 75 years is limited. I recommend screening tests based on the functional status of the person and not solely on age. Estimated life expectancy and expected time to benefit from the test are other factors to consider. For example, selective screening tests could be appropriate for an 80-year-old woman who is active and highly functional while the same screening tests are not indicated for a 75-year-old man who has advanced dementia and is now bedbound.

Why does bone density decrease with age? Can it be prevented?

Our bone is constantly undergoing remodeling; old bone is removed and new bone is added. These two processes — bone resorption (removal) and bone formation change with aging. After age 35 or so, bone resorption outpaces formation and therefore bone density, or bone strength, begins to decline. Bone loss can be prevented by not smoking, engaging in regular physical activity, eating a diet rich in calcium, and eating foods fortified with vitamin D or taking vitamin D supplements. In addition, bone density can be tested by x-ray to check for osteoporosis or weak bones. Osteoporosis can be treated with medications to improve bone strength.

Do older adults require less sleep than younger adults?

As people age they tend to have difficulty falling asleep and more trouble staying asleep. It is a myth that older adults need less sleep than younger adults. In fact, research shows that our sleep needs remain constant throughout adulthood. What changes are sleep patterns, which can lead to sleep problems.

Is it possible for older adults to change unhealthy habits, such as smoking?

Yes. It is never too late to change many of these unhealthy habits, such as smoking. Many benefits of smoking cessation (including reduced risk of cardiovascular problems) can be seen within a few months of quitting.