When you’re a kid, getting older seems magical: fewer restrictions and more freedom! As an adult, however, you realize that aging brings with it quite a few concerns, some you might not have thought about. To keep enjoying life, you have to make healthy choices and stay active. Below are suggestions from local experts on how to adapt and maintain.

skin care: do you need to switch products?
Might there come a time to move on from your trustworthy and beloved skin products? “Often the skin changes with age, and how it responds to products changes,” says Carol Anderson, RN, CANS, certified aesthetic nurse specialist and owner of Nouveau, A Boutique MedSpa in Kirkwood. “When people have loved the same products forever, they can miss those changes. One day they look in the mirror and say, ‘Wow! What happened?’ What they used five years ago is probably not what they need today.”

Although time ages the skin, Anderson says sun exposure is responsible for 90 percent of damage. “Health issues, nutrition, sleep, diet and lifestyle also determine how much collagen breaks down,” she says. “We can protect our skin with sunscreen, a healthy diet, and internal and topical Vitamin C. Tretinoin, a prescription version of Retin-A, will cause cellular turnover and create new collagen. Topical products that have a combination of alpha hydroxy and beta hydroxy acids can create collagen, too.”

Collagen maintains the firmness of the underlying tissues that keep the skin’s surface smooth and soft, Anderson notes. “We always need new collagen to keep the skin supple and avoid crepiness. The biggest collagen stimulation will come from deeper treatments with heat and light, like laser, infrared or radiofrequency.” A care provider who understands evolving skin can help fine-tune your regimen, she says. “As we age, we need to change the way we treat. Even after three months, we will reassess and may alter the nutrients and products we recommend for your skin.”

vaccines: what is recommended?
The aging immune system may not be ‘broken,’ but it’s likely wearing down. Even if you received all of the recommended vaccinations earlier in life (or caught the common childhood diseases), you may be due for booster shots and new vaccines.

“Up to age 65, unless you develop a chronic disease, the immune system mostly stays very healthy,” says Dr. John Morley, a SLUCare geriatrician and director of the division of endocrinology, diabetes and metabolism at Saint Louis University School of Medicine. “A vaccine helps your immune system recognize a challenge it has been exposed to in
the past so it will respond quicker and kill off the challenge. As we get older, our immunity becomes lethargic. The
memory cells disappear or decrease in number.” For that reason, it is recommended that some vaccinations be repeated, Morley says.

important vaccines
>> Pneumococcal vaccines have to be renewed even if you had them as a child. For adults 65 or older, the CDC recommends PCV13 for those who previously haven’t had it and PPSV23 one year later.
>> The DPT (diphtheria, pertussis and tetanus) vaccination should be scheduled every 10 years.
>> Morley says if you have had chicken pox, you still need to get the shingles vaccine. The new Shingrex vaccine for herpes zoster should be given to everyone over the age of 50.
>> Despite years of it not appearing to help, an annual influenza vaccination is important. “Future vaccines should be improved,” Morley notes. “As you get older, influenza can kill you. Scientists are working on quicker-to-develop vaccines that will work against strains we are most likely to have.”

alcohol: is that extra glass of wine still OK?
Fine wines improve with age, but our ability to metabolize them doesn’t. “As we get older, alcohol tends to have an increased impact on our health,” says Craig McKnight, director of MediNurse, a provider of private-duty nursing care for the St. Louis area. “The rate of metabolic consumption slows down, so little to moderate drinking can have greater effects. It’s important to consider a person’s weight, medications and medical conditions. Unfortunately, alcohol abuse is an often overlooked problem in seniors, and symptoms can be misdiagnosed as other health conditions.”

While some research studies report that moderate drinking can have a positive general health impact, this may not apply to seniors. Age-related physical changes alone reduce the body’s tolerance for alcohol, McKnight says. For older adults facing illnesses or chronic ailments or taking medications (even over-the-counter ones), any amount of alcohol can exacerbate health conditions and, in extreme cases, cause death. “It causes changes in the heart and blood vessels, which are capable of dulling pain that could be a warning sign for other health conditions,” McKnight says.

For healthy seniors, moderate drinking is considered to be ½ to 1 ounce of pure alcohol daily for women and 2 ounces for men. This equates to about a 12-ounce beer, 5 ounces of wine or 1.5 ounces of distilled spirits.

warning signs of excessive drinking:
>> Fatigue
>> Irritability
>> Poor balance
>> Insomnia
>> Chronic pain
>> Blurred vision

Over time, it can lead to …
>> Cancer
>> Liver damage
>> Immune system disorders
>> Brain damage

It can worsen conditions like …
>> Osteoporosis
>> Diabetes
>> High blood pressure
>> Stroke
>> Ulcers
>> Memory loss
>> Mood disorders

teeth: taking care of an aging mouth
Your teeth and dental work are meant to be permanent but not maintenance-free, says Dr. Scott Mahlin, a dentist and oral surgeon at Clarkson Dental Group in Chesterfield. “Ongoing, continued dental care is important for overall health,” he notes.

Dental cavities are not only afflictions of childhood. Gum disease can occur at any age, and the aging mouth brings additional concerns that may affect more than the teeth and gums. “There is a definitive mouth-body connection,” Mahlin says. “Many people are unaware that gum disease, or destruction of the gums and surrounding bone, may affect your general health.”

The American Dental Association (ADA) advises older adults that their dental care is even more important than it was during their early years. “Your mouth changes as you age,” Mahlin notes. “The nerves in your teeth can become smaller, making your teeth less sensitive to cavities or other problems. If you don’t get regular dental exams, you can have problems that aren’t diagnosed until it is too late. If cared for properly, your teeth can last a lifetime.”

fitness: should your routine change as you age?
A finely tuned senior body should continue to exercise at a high level, just with a bit more care, says Andy Hayes, fitness manager at the JCC-St. Louis Chesterfield Gym and Fitness Center. “If you want to create a fitness life that is going to extend as long as possible, you definitely should change things up as you advance in years,” he says.

The differences? A greater focus on mobility and warming up at the beginning of sessions, Hayes suggests. “Do some light stretching exercises or yoga poses. Foam rolling for self-myofascial release (SMR) is also beneficial.” SMR releases trigger points in the joints and muscles. “You want to get your body warmed up not only temperature-wise, but also neurologically,” Hayes notes. “The neuro stimulus is important; start slowly and gradually increase, either in intensity or with weight.”

To compensate for a lifetime of joint use, Hayes shows clients how to lift with lighter weights. “After the age of 40, joints can be damaged,” he says. “To make lighter weights seem more challenging, do slower, negative lifting, which means lowering the weights in a more controlled way. Before you lower them all the way, do isometric pauses for four to six seconds. Your muscles will feel fatigued, but your joints are not going to be screaming.”

Hayes also suggests alternating high-intensity workouts with easier recovery days. As you get older, you may not be able to do superintensive aerobic work every day. Don’t ever assume fatigue is inevitable. “You don’t have to accept that your energy gets lower as you get older,” he says. “The best recipe for better energy is a good diet low in processed foods and high in vegetables, lean meats and fruits; quality rest; and frequent exercise.”

feet: what is the best support?
Your favorite old, comfy shoes might be broken in too much to support your aging feet, says Dr. Richard Brickhouse, a podiatric surgeon who practices at SSM Health St. Mary’s Hospital.

“Generally, as people age, they have changes in their joint structure and foot architecture,” he notes. “With certain foot types, you can get deformities such as hammertoes and bunions. A lot of that is hereditary.” In the absence of a
diagnosed condition, seniors should wear a stable shoe that is fairly rigid, Brickhouse says. “You want to prevent any sort of progressive problem or ligament strains,” he notes. He recommends shoe stores that employ a therapeutic shoe fitter, such as one certified by the American Board for Certification in Orthotics, Prosthetics & Pedorthics. “People who have arthritis, diabetes, flat feet or high arches may need to wear special shoes, orthotics or braces to reduce the progress of these problems,” he says.

Brickhouse strongly advises against wearing high heels. “A long-term effect of high heels is tightening of the Achilles tendon because it is in a contracted condition, and that can lead to other problems and deformities,” he explains.