Diseases through the decades – here's what to look out for in your 40s, 60s, 80s and beyond

by Stephanie Harrison, Azmeraw T. Amare, Jyoti Khadka, Maria Carolina Inacio, Sarah Bray And Tiffany Gill, The Conversation

Achieving and maintaining a healthy weight will set you up for decades of better health. Credit: Sue Zeng

Many diseases develop and become more likely as we age. Here are some of the most common conditions, and how you can reduce your risk of getting them as you clock over into a new decade.

In your 40s

11 jan 2019--Maintaining a healthy weight can reduce the risk of developing arthritis, coronary heart disease, and other common and related conditions, including back pain, type 2 diabetes, stroke, and many cancers. But almost one-third of Australians in their 40s are obese and one in five already have arthritis.

From the age of 45 (or 35 for Aboriginal and Torres Strait Islanders), heart health checks are recommended to assess risk factors and initiate a plan to improve the health of your heart. This may include changing your diet, reducing your alcohol intake, increasing your physical activity, and improving your well-being.

Checks to identify your risk of type 2 diabetes are also recommended every three years from age 40 (or from age 18 for Aboriginal and Torres Strait Islanders).

If you don't already have symptoms of arthritis or if they're mild, this decade is your chance to reduce your risk of the disease progressing. Focus on the manageable factors, like shedding excess weight, but also on improving muscle strength. This may also help to prevent or delay sarcopenia, which is the decline of skeletal muscle tissue with ageing, and back pain.

Most people will begin to experience age-related vision decline in their 40s, with difficulty seeing up close and trouble adjusting to lighting and glare. A baseline eye check is recommended at age 40.

In your 50s

In your 50s, major eye diseases become more common. Among Australians aged 55 and above, age-related macular degeneration, cataracts, diabetes-related eye diseases and glaucoma account for more than 80% of vision loss.

A series of health screenings are recommended when people turn 50. These preventive measures can help with the early detection of serious conditions and optimising your treatment choices and prognosis. Comprehensive eye assessments are recommended every one to two years to ensure warning signs are detected and vision can be saved.

National cancer screening programs for Australians aged 50 to 74, are available every two years for bowel and breast cancer.

To screen for bowel cancer, older Australians are sent a test in the post they can do at home. If the test is positive, the person is then usually sent for a colonoscopy, a procedure in which a camera and light look for abnormalities of the bowel.

In 2016, 8% of people screened had a positive test result. Of those who underwent a colonoscopy, 1 in 26 were diagnosed with confirmed or suspected bowel cancer and one in nine were diagnosed with adenomas. These are potential precursors to bowel cancer which can be removed to reduce your future risk.

To check for breast cancer, women are encouraged to participate in the national mammogram screening program. More than half (59%) of all breast cancers detected through the program are small (less than or equal to 15mm) and are easier to treat (and have better survival rates) than more advanced cancers.

In your 60s

Coronary heart disease, chronic obstructive pulmonary disease(a disease of the lungs that makes breathing difficult), and lung cancer carry the biggest disease burden for people in their 60s.

If you're a smoker, quitting is the best way to improve both your lung and heart health. Using evidence-based methods to quit with advice from a health professional or support service will greatly improve your chances of success.

The build-up of plaques in artery walls by fats, cholesterol and other substances (atherosclerosis) can happen from a younger age. But the hardening of these plaques and narrowing of arteries, which greatly increases the risk of heart disease and stroke, is most likely to occur from age 65 and above.

Exercise protects against atherosclerosis and research consistently shows any physical activity is better than nothing when it comes to heart health. If you're not currently active, gradually build up to the recommended 30 minutes of moderate-intensity exercise on most, preferably all, days.

Other potentially modifiable risk factors for stroke include high blood pressure, a high-fat diet, alcohol consumption, and smoking.

Your 60s is also a common decade for surgeries, including joint replacements and cataract surgery. Joint replacements are typically very successful, but are not an appropriate solution for everyone and are not without risks. After a joint replacement, you'll benefit from physiotherapy, exercise, and maintaining a healthy weight.

The treatment for cataracts is to surgically remove the cloudy lens. Cataract surgery is the most common elective surgery worldwide, with very low complication rates, and provides immediate restoration of lost vision.

In your 70s

Many of the conditions mentioned above are still common in this decade. It's also a good time to consider your risk of falls. Four in ten people in their 70s will have a fall and it can lead to a cascade of fractures, hospitalisations, disability and injury.

Osteoporosis is one cause of falls. It occurs most commonly in post-menopausal women but almost one-quarter of people with osteoporosis are men. Osteoporosis is often known as a silent disease because there are usually no symptoms until a fracture occurs. Exercise and diet, including calcium and vitamin D, are important for bone health.

Older people are also vulnerable to mental health conditions because of a combination of reduced cognitive function, limitations in physical health, social isolation, loneliness, reduced independence, frailty, reduced mobility, disability, and living conditions.

In your 80s and beyond

Dementia is the second most common chronic condition for Australians in their 80s, after coronary heart disease – and it's the most common for people aged 95 and above.

Many people think dementia is a normal part of the ageing process, but around one-third of cases of dementia could be prevented by reducing risk factors such as high blood pressure and obesity at mid-life.

Early diagnosis is important to effectively plan and initiate appropriate treatment options which help people live well with dementia. But dementia remains underdiagnosed.

Around 70% of Australians aged 85 and above have five or more chronic diseases and take multiple medications to manage these conditions. Effective medication management is critical for people living with multiple conditions because medications for one condition may exacerbate the symptoms of a different coexisting condition.Provided by The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

New research finds 'mind over matter' key to a healthy lifestyle

Credit: CC0 Public Domain

People who want to increase their participation in regular exercise and adopt a healthier lifestyle may be best to mentally visualise it, new research by Curtin University has found.

09 july 2018--The research, published in the leading journal Health Psychology, found that 'mental imagery interventions', or visualising an activity or task, may be effective in helping people change their behaviours, including moderating alcohol consumption and participating in regular physical activity.
Lead Australian author John Curtin Distinguished Professor Martin Hagger, from the School of Psychology at Curtin University, said the research aimed to explore the link between visualisation and increasing healthy behaviour.
"There are strong links between chronic illnesses like heart disease and diabetes and behaviour, and imagery-based interventions offer an inexpensive, effective way of promoting healthy behaviours such as physical activity and healthy eating," Professor Hagger said.
"We found that people who simply visualised the steps necessary to do the healthy behaviour on a regular basis were more likely to be motivated, and actually do, the healthy behaviour."
Mental imagery was also more effective in promoting healthy behaviours when the visualisation lasted longer, when people were reminded to do their imagery by text message, and when the person was given detailed instructions on how to conduct the imagery exercise.
Professor Hagger explained that the research could have important implications for health professionals and the broader community around the world.
"Previous studies have shown that imagery interventions have been used in various contexts including enhancing athletes' performance, flight simulation training for aircraft pilots and for symptom relief in hospital settings. Our research shows that imagery is also effective for promoting participation in healthy behaviours," Professor Hagger said.
"Our findings may not only be of interest to health professionals around the world, but could be of interest and potentially implemented within other industries."

More information: Dominic Conroy et al. Imagery interventions in health behavior: A meta-analysis., Health Psychology (2018). DOI: 10.1037/hea0000625


Provided by Curtin University

Most doctors ignore one of the most potent ways to improve health, experts say

Escalating rungs of social support. Credit: Penn Medicine

Leveraging existing relationships with friends and family may be a more effective way to improve patients' health and encourage new healthy habits and behaviors than increasing interactions with physicians or other clinicians. In a new perspective published by the New England Journal of Medicine, Penn Medicine behavioral economists suggest a five-step ladder to effectively engineering social engagements that promote health and to test their acceptability and effectiveness.

30 dec 2016--"Spouses and friends are more likely to be around patients when they are making decisions that affect their health - like taking a walk versus watching TV, or what to order at a restaurant. Patients are also more likely to adopt healthy behaviors - like going to the gym - when they can go with a friend," explains co-author David Asch, MD, MBA, a professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania and director of the Penn Medicine Center for Health Care Innovation. "Though people are more heavily influenced by those around them every day than they are by doctors and nurses they interact with only occasionally, these cost-free interactions remain largely untapped when engineering social incentives for health. That's a missed opportunity."
Because of these lost opportunities, and the high costs when doctors and nurses keep tabs on their patients, the authors say it's important to engineer social engagements that enlist the social support patients already have, and allow organizations to test their acceptability. "Concerns about privacy are often the reason doctors and hospitals avoid organizing social support," Asch says. "But while privacy is very important to some patients under some circumstances, more often patients would love if their friends and family helped them manage their diabetes, and those friends and family want to help people get their health under control."
The authors define a ladder with escalating rungs of social support ranging from no social engagement - such as when a patient is expected to take medication as part of a routine, without anyone seeing them do it or holding them accountable - to a design that relies on reputational or economic incentives, and incorporates teams or other designs that hold patients accountable for their health behaviors and habits.
"Although we don't normally think of competition or collaboration among patients are part of managing chronic diseases like high blood pressure, heart failure, or diabetes, research shows that behavior is contagious, and programs that take advantage of these naturally occurring relationships can be very effective," said co-author Roy Rosin, MBA, chief innovation officer at Penn Medicine. "Most health care interventions are designed for the individual patient, but there's a growing body of research that shows how health care organizations can use social engagement strategy to enhance health for patients who want to be involved in group activities or team competitions aimed at improving health."
For example, in the fourth rung, where social incentives are designed with reciprocal support, the authors point to a study in which some patients with diabetes were asked to talk on the phone weekly with peers—a technique known as reciprocal mentorship—and others received more typical nurse-led management. Results showed that those who worked directly with peers saw a more significant decline in glycated hemoglobin levels than those who worked with clinical staff.
"Sure, health care is serious business," Asch says, "but who says it can't be social?"


Provided by Perelman School of Medicine at the University of Pennsylvania

Study suggests increase in public health spending results in healthier people

A groundbreaking new study published in the journal, Health Affairs, suggests that increases in public health spending result in healthier people, especially in communities with fewer resources.

07 aug 2011--The study was co-authored by Glen P. Mays, the new F. Douglas Scutchfield Endowed Professor in Health Services and Systems Research at the University of Kentucky College of Public Health. At UK, Mays is affiliated with the National Coordinating Center for Public Health Services and Systems Research, funded by the Robert Wood Johnson Foundation. Sharla A. Smith, a research associate in the Department of Health Policy and Management, University of Arkansas for Medical Sciences, co-authored the study.

The study examined whether changes in spending by local public health agencies over a 13-year period contributed to changes in rates of community mortality from preventable causes of death, including infant mortality and deaths due to cardiovascular disease, diabetes and cancer.

The researchers found for every 10 percent increase in local public health spending, mortality rates from the four causes of death analyzed dropped anywhere from 1 percent to almost 7 percent.

"In light of the Affordable Care Act that authorized the largest expansion in federal public health spending in decades, coupled with an economic downturn that has precipitated large cuts in state and local government support for public health activities, it's critical to take a data-driven look at whether public health spending translates to improved health of our population," Mays said.

It's important to examine not only how much was spent, but also how it was spent, Mays said. "Our findings suggest that a connection between spending and health outcomes does exist, although it's important to note that resources must be successfully aimed at activities that target at-risk population groups to ensure that spending is resulting in positive outcomes."

Previously, little research has been done in the area of the impact of public health spending on population health. Mays and Smith analyzed changes in spending patterns and mortality rates within the service areas of the nation's nearly 3,000 local public health agencies over a 13-year period.

Increases in public health spending were associated most significantly with reductions in deaths for four of the six mortality rates, with the strongest effects for infant mortality and cardiovascular disease mortality.

After accounting for differences in demographic and socioeconomic characteristics, medical resources and other factors, communities that made the largest investments in public health spending experienced the most significant reductions in mortality from leading preventable causes of death.

"Although a definitive causal link between spending and mortality cannot be drawn, the study does provide compelling evidence that communities must pay attention to more than local medical resources and interventions, but also to the resources invested in local public health activities to truly make a difference in the health of their people," Mays said.

Public health spending varies widely around the country. For example, per capita state public health spending ranged from a low of less than $4 in Nevada to a high of more than $171 in Hawaii. Local public health spending varied even more significantly – ranging from less than $1 per capita to more than $200 per capita, with the median spent around $36 per person.

The study provides a foundation for further research, particularly in light of the ACA investment of a projected $15 billion in new spending over 10 years in federal public health spending and the continued reductions in state and local government spending for public health, Mays said.

Provided by University of Kentucky

Accord on core competency, standards and quality assurance in health promotion and education
Global consensus conference reaches accord and issues statement

GALWAY, IRELAND, 4 july 2008 – In response to the global health crisis, 26 leading authorities in competency-based and accreditation movements in global health promotion, health education, and public health reached an accord last week on what should comprise the domains of core competency in health promotion and health education.
The conference, the first of its kind, was co-chaired by Prof. Margaret Barry of the National University of Ireland, Galway, who serves as the global vice-president for capacity-building, education and training for the Paris-based International Union for Health Promotion and Education (IUHPE), and Prof. John Allegrante of Columbia University, a past president of the Society for Public Health Education (SOPHE) in Washington, DC.
The conference addressed the development and implementation of credentialing systems to strengthen global capacity in health promotion—a critical element in achieving goals for the improvement of global health.
A consensus statement issued by the organizers identified eight domains of core competency that are required to engage in effective health promotion practice. They are Catalyzing change, Leadership, Assessment, Planning, Implementation, Evaluation, Advocacy, and Partnerships.
The statement also asserts that "Acquiring proficiency in the domains of core competency will require setting standards and developing quality assurance mechanisms that are practice-based and periodically updated," and that "standards and quality assurance mechanisms . . . need to be in place in all countries."
Barry, professor of health promotion and public health, and director of the Health Promotion Research Centre at the National University of Ireland, Galway, said that "The transcontinental quality-assurance efforts share common goals: to protect the public by establishing and assuring a minimum acceptable standard of quality and performance for practitioners of health promotion; to improve or strengthen academic preparation through systems of peer review; and to promote continued professional development of the workforce."
The consensus statement will now be circulated among professionals, employers, and other interested groups for comment over the next six months. The final statement, along with the background papers that informed the conference deliberations, will be published by IUHPE and SOPHE within the next year. The draft consensus statement, along with links to a public comment page where comments, suggestions, and recommendations may be posted, can be found at www.iuhpe.org and www.sophe.org.
Allegrante, who is professor of health education and chairman of the Department of Health and Behavior Studies at Columbia University Teachers College, and adjunct professor of public health in sociomedical sciences at the Columbia University Mailman School of Public Health, said that "The final consensus statement will constitute a roadmap by which nations around the world can strengthen workforce capacity." He also said that "This will be essential if both rich and poor countries are to make progress in creating the social circumstances that we know can improve health and the human condition."