Health After 40: What You Need to Know
Forty may be the new 30, but turning the big 4-0 can still trigger health questions and worries. Do you wonder if weight gain, hypertension, and osteoarthritis are looming in your immediate future? Get some answers to your most pressing - and worrying - questions about health after 40.
Q. Can I keep up my exercise regimen when I reach 40.
A. Yes. Barring any major medical problems, the CDC recommends daily exercise as a healthy part of aging. According to the 2008 Physical Activity Guidelines for Americans, you should do moderate-intensity aerobic exercises such as brisk walking and doubles tennis at least 2 ½ hours a week.
If you prefer vigorous-intensity activities such as jogging, swimming laps or singles tennis, try to do at least 1 ½ hours weekly. Include muscle-strengthening exercises two days a week as well. Before you begin any exercise routine get a complete medical checkup.
Q. Is gaining fat inevitable at 40?
A. No. As you age your metabolism slows down, you lose muscle mass, and estrogen can increase the amount of fat you store around your stomach. All of these factors may cause you to gain weight, but it isn't inevitable.
If you're in otherwise good health (for instance, you don't have a thyroid problem) gaining weight comes down to consuming more calories than you're burning. If you're physically active on a regular basis, eat healthy balanced meals and get enough sleep, you should be able to maintain your weight for many years.
Q. Can I have a baby safely after 40?
A. Possibly. But, the risks are definitely higher. After age 40 a first-time pregnant woman is more likely to develop high blood pressure, and has a four times greater risk of developing diabetes. The risk of placenta previa and miscarriage is also much higher.
The American College of Obstetricians and Gynecologists (ACOG) also point out that pregnancy after 40 is more associated with preterm delivery, low birth weight, and infant death. Also, a woman aged 40 has a 1 in 66 chance of having a baby with a chromosomal disorder such as Down syndrome and Fragile X syndrome, compared to a risk of 1 in 192 for a woman 35 years old.
Q. Will turning 40 increase my risk of hypertension?
A. Not necessarily. This is one of the most common concerns about health after 40. While the likelihood of developing hypertension increases as you age, men are more likely to get it in early middle age than women; women are more at risk after menopause. However, there are many lifestyle changes you can make to avoid getting high blood pressure, such as losing weight, reducing your salt, caffeine and alcohol intake, limiting stress, and getting regular physical activity.
Q. How often do I need a pap test after 40?
A. It varies. According to ACOG, women over 30 who have had three normal pap smears in a row may only need to do the test every two or three years. If you've been treated for cancer, have HIV, a weakened immune system, or been exposed to the drug diethylstilbestrol (DES) before birth, you should have more regular pap tests. Consult your doctor to find out if you need a pap test if you've had a hysterectomy.
Q. How often do I need a mammogram?
A. There's no standard recommendation. The American Cancer Society recommends getting annual mammograms starting at age 40. However, there is still debate about testing frequency within the medical community.
Guidelines published in the Annals of Internal Medicine indicate that the risk of breast cancer can rise from 0.6 percent for a woman age 40 with no risk factors to six percent for a woman age 49 with some risk factors. Factors that increase your chances of getting breast cancer include older age, family history of breast cancer, older age at the time of your first baby, younger age at menarche, and history of breast biopsy. In the absence of standard intervals for testing, the researchers recommend that doctors assess their female patients' risk every one to two years.
Q. How often do I need a vision test after 40?
A. It depends. If you have diabetes, a history of eye disease or injury or you're an African-American over age 40, you may need more frequent eye exams than other people, states the American Academy of Ophthalmology.
However, presbyopia, the natural age-related loss of eye focusing ability, usually begins between ages 38 and 45. The Academy now recommend that adults with no signs or risk factors for eye disease get a baseline eye disease screening at age 40. This test allows early detection of eye diseases common in adults over age 40 and helps prevent unnecessary loss of vision. Based on the results of this test, your eye doctor can recommend how often you should schedule follow-up visits.
Q. How great is my risk of type 2 diabetes after 40?
A. It depends. About 90 to 95 percent of people with diabetes have type 2 diabetes. The American Medical Association reports that this form of diabetes usually occurs in adults over age 40 and most commonly in adults over age 55. However, 80 percent of people with type 2 diabetes are overweight.
You're also more likely to get the disease if you have a family history (parents or siblings with the disease), you had gestational diabetes, or you're of African, Hispanic/Latino, or Native American descent. Some people of Asian and Pacific Island descent also have a higher risk of type 2 diabetes. If you fall into any of the risk categories, your doctor should screen you at your regular medical checkups.
Taking care of your health after 40 will require more attention than when you were in your 20s, but don't let it become a burden. For specific health concerns, see your doctor sooner rather than later to put your mind at rest and avoid medical complications.
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