The goals of prevention in an older adult usually depend on the person's health, level of function, and risk profile. For example, a healthy, independent person with no serious disorders may focus mainly on preventing disorders from developing. A person with several mild chronic disorders who remains independent may focus more on preventing or slowing decline in function and avoiding frailty than on preventing new disorders. A frail person with several advanced chronic diseases who has become mostly dependent on others may focus mainly on preventing accidents and complications that could cause further loss of independence or death.

Lifestyle: Exercise, including aerobic exercise, is still important. Weight lifting helps protect against muscle weakness, age-related loss of muscle tissue, and osteoporosis by strengthening muscles and increasing bone density. Aerobic exercise increases endurance and may slightly lower the risk of some heart and blood vessel disorders. In older adults, dancing and tai chi may be enjoyable forms of exercise and may have additional benefits, such as enhancing balance and preventing falls.

Stopping smoking is helpful even in older adults. It can help improve endurance at any age, decrease symptoms of certain disorders (such as angina and claudication), and may decrease risks of certain disorders developing (such as heart attacks).

Alcohol is metabolized differently in older adults. Older adults who drink alcohol need to be aware that more than one drink per day may increase their risk of injuries and other health problems.

Did You Know... Preventing falls, restricting driving (when necessary), and understanding the side effects of drug therapy can greatly increase the chance of good health for certain older adults.

Drugs and Vaccines: Understanding drug therapy is particularly important for older adults because they are more susceptible to adverse drug effects (see Aging and Drugs). Factors that can increase susceptibility include age-related differences in drug metabolism and use of many drugs (which can lead to drug interactions). A primary care doctor and pharmacist can provide information on all prescription and nonprescription drugs. Knowing the brand and generic name of all drugs taken; each drug's purpose; the length of time each drug is to be taken; and what activities, foods, drinks, and other drugs are to be avoided while taking a drug can help older adults avoid problems. Older adults should bring all of their drugs, both prescription and nonprescription, to their doctor appointments so that they can be reviewed with their doctor.

Vaccines for influenza, pneumococcal pneumonia (a bacterial lung infection), and the combination of pertussis and tetanus are important for older adults because of their increased susceptibility to pneumonia and tetanus.

Spotlight on Aging
Measures that prevent injuries in younger adults are also important in older adults. So are some additional measures. For example, driving should be avoided in people whose vision, reflexes, or overall function is poor. Driving should also be avoided when taking drugs that cause sedation and at night if night vision is poor. Falls are a leading cause of serious health problems in older adults. Health risks can be reduced by preventing falls in the following ways: Clean up cluttered areas in the home Remove or secure throw rugs, edges of carpet, and uncovered phone and electrical cords to the floor Maintain adequate lighting Add handrails, grab bars, and traction/non-skid surfaces (such as strips or nonslip bathmats) to stairways and bathtubs as needed Install handrails near the toilet and in the tub and shower Avoid use of slippery bath oils Review drugs to eliminate unnecessary ones and reduce others to lowest effective dose Preserve or improve balance (for example, by exercise, dance, or tai chi) to decrease the risk of falls

Last full review/revision September 2007 by James T. Pacala, MD, MS