What doctors wish patients knew about healthy aging

AMA News Wire

What doctors wish patients knew about healthy aging

Sep 12, 2025

We’ve seen actress Betty White live to the age of 99 and Queen Elizabeth II reach the age of 96, serving as monarch for more than 70 years. This has a lot to do with healthy aging, which shouldn’t begin as an older adult. It should be top of mind even in your college years or earlier. And while there are many factors that influence healthy aging, some of these—such as genetics—are not in our control. That is why knowing what steps to take is key.

Healthy aging is an ongoing process of maintaining and improving physical and mental health. This can help to ensure independence, security and productivity as you age. Yet millions struggle with health and safety challenges such as chronic disease, falls and mental health problems, which can severely impact quality of life. 

The AMA’s What Doctors Wish Patients Knew™ series gives physicians a platform to share what they want patients to understand about today’s health care headlines and how to take charge of their health through preventive care.

In this installment, three physicians took time to discuss what patients need to know about maintaining physical and mental health as they age. These AMA members are:

• Edward T. Bope, MD, a family physician in Columbus, Ohio and immediate past chair of the AMA Senior Physicians Section (AMA-SPS) Governing Council.
• Jenny L. Boyer, MD, PhD, JD, a full-time telemedicine psychiatrist in central Oklahoma and chair of the AMA-SPS Governing Council.
• Keerthana Pakanati, MD, an internal medicine board-certified physician and chief cardiovascular disease fellow at Virginia Mason Franciscan Health.
• Louis Weinstein, MD, an ob-gyn and maternal-fetal medicine specialist in Charleston, South Carolina. 

Virginia Mason Franciscan Health is part of the AMA Health System Member Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to help drive the future of medicine.

“A lot of people think healthy aging is just in reference to the absence of disease, but it really encapsulates other things. It encapsulates your physical, mental and social health too,” said Dr. Pakanati. “The things that I really focus on for health aging are things that I tell my patients all the time—physical activity, healthy eating, good social support and engagement.”

“Healthy aging means avoiding illness as much as possible and dealing with illness when it occurs. We need to pay attention to this because how we age matters,” said Dr. Bope. “It really matters on the final outcome, the way you take care of the body, the way you preserve your ability.”

Additionally, Dr. Boyer emphasized that “healthy aging is about prolonging the length of time you are aging without disability, the length of time you are able to do all the things you want to do and reducing the length of time you are aging with physical or mental challenges.” 

“A key focus of healthy aging is prevention and making healthy lifestyle choices in your 40s, 50s, 60s, 70s so that your 80s and 90s are healthier,” she said.

“Without the component of health, it’s a very difficult time for most people and, ultimately, all of us are going to experience some abnormalities in our health,” Dr. Weinstein said. “It’s only a matter of when, not if, but clearly there are ways to prolong the onset of conditions that will affect your health.” 

A key part of healthy aging is “keeping up to date with chronic-disease management and prevention,” said Dr. Pakanati. That means “staying up to date on your preventive care, whether that’s cancer screenings or vaccinations.”

It’s also about “taking your health literacy seriously and educating yourself,” she said. “All of this works together. It’s not just one piece of the pie, but rather that everything has to fit together and you can’t focus on one thing without the other.”

“It’s a lifelong habit to take care of yourself, but it also matters what happens when you go through different phases in your life,” said Dr. Bope, adding that it is “the phase when children leave home, the phase when you retire, how you become acclimated to a new social situation, how you take care of yourself in regards to your diet and how you would take care of yourself in the way of exercise.”

“Now, all of this really has a lot to do with what your abilities are, and we’re given different abilities,” he said, noting that “some people don’t have as good a musculoskeletal system as others as they age, and some people will have memory problems earlier than other people or vision problems or hearing problems.”

“It’s optimal, of course, when all of those things continue at their previous level and all you have to do is just maintain them,” said Dr. Bope. “It’s more difficult when some of them start to change and you have to adapt to that.”

“I can’t tell you how many senior patients—and even women in their fifties—are having mobility problems. It’s just extraordinary,” Dr. Weinstein said, adding that “mobility is one of the keys to physical well-being.”

“A simple check is to see if you can get out of a chair without using your arms,” said Dr. Boyer. “If you struggle with this, you might talk to your doctor about physical therapy or an exercise program to improve core strength and prevent loss of mobility.”

“People talk about how you need to run, jump, weight lift or swim, but I don’t care what type of mobility it is,” Dr. Weinstein said. “If you’re getting up and down from a chair, that’s mobility. Pushing against the wall, that’s mobility. Just maintain mobility in any form.”

“As we age, there are both structural and functional changes in the brain that all contribute to that gradual decline in memory, but also in processing speed,” said Dr. Pakanati. “Not only do we sometimes forget things, but we also take a little bit longer to understand them or execute them.”

To help, “make sure you have aerobic and resistance exercise—are you incorporating resistance exercise and weight training with regular physical activity? Because that can actually sl     ow cognitive decline,” she said, noting “the American Heart Association, for people 65 or older, they recommend 150 minutes of moderate activity or 75 minutes of strenuous activity. And they recommend that you do a couple days of weightlifting and resistance exercise as well.” 

“As patients get older, if they’re having hearing loss or visual impairment, that can also cause them to kind of retreat a little bit because they don’t want to keep asking people to repeat themselves in conversations,” said Dr. Pakanati, “or maybe they feel like they can’t participate in social activities because of their hearing. 

“So, make sure you’re staying up to date on sensory deficits because that could actually reduce that risk of cognitive decline quicker,” she added. 

American journalist “Norma Cousins wrote a great article in The New England Journal of Medicine years ago about his chronic disease and how his attitude markedly influenced his chronic disease,” explained Dr. Weinstein. “So, attitude is important. Every one of us is going to have setbacks, unquestionably, but how you approach the setback is what effect it will have on you as you age.”

“And you can adjust your attitude. There’s no medicine for attitude. You can’t go take two Aspirin and get your attitude better,” he said. “But you can choose what your attitude is and how you approach situations knowing that things are going to happen to all of us.”

“Sleep is such a big one that we don’t talk about because as we get older, we      don’t sleep as well as we used to,” said Dr. Pakanati. “And we know that any sleep disorder, whether that’s insomnia or sleep apnea, is linked to increased risk of stroke, cognitive decline and Alzheimer’s disease.”

“If your sleep duration and the quality of your sleep are not good, those are both related to higher dementia risk as well,” she said. “So, it’s important that not only are we targeting that seven to nine hours per night, but we’re also treating patient sleep disorders.” 

“There are four very serious unhealthy habits: smoking, alcohol, salt intake and processed foods,” said Dr. Weinstein. “While there are all kinds of diets, if you can decrease your salt intake and limit processed foods, you can improve your health.”

“In aging—as in all ages—it’s good to have a balance in your nutrition,” said Dr. Bope. “You really should still be having a good breakfast, which is something many older people skip, but that’s a good foundation for the day. And then tapering your calories off a little bit as the day goes on.”

“A healthy diet and exercise are good for everyone, regardless of age,” said Dr. Boyer. “But if you are losing weight, make sure you let your doctor know so you aren’t missing something that could be treated.”

“Continuing those good habits, keeping in mind that as patients get older, they may not have the ability to cook those super healthy great meals all the time,” Dr. Pakanati said, “but trying to focus on selecting foods that align more with a Mediterranean diet and DASH diet—which stands for Dietary Approaches to Stop Hypertension—but still being cognizant that not everyone does everything a 100% of the time.”

“Your brain health affects your heart health, and your heart health affects your brain health,” said Dr. Pakanati. “When we think about it, the mechanism behind a stroke and the mechanism behind a heart attack is very similar. 

“Emphasizing optimal heart health—not smoking, a healthy diet, regular physical activity, treating your chronic conditions, and watching your cholesterol, your blood sugar and your blood pressure—can help with a lower risk of cognitive decline and then dementia as well,” she added. 

“One issue that really can affect so much of what a senior does through healthy aging and emotional stability is vision. We know that vision deteriorates as we age—whether it’s cataracts, age-related macular degeneration or diabetic retinopathy—but so much of vision can either be corrected, maintained or stabilized,” said Dr. Weinstein. “If you lose vision, you lose so much because you lose your ability to function easily in the world, which has a huge emotional impact.

“Hearing can be corrected by hearing aids, but vision is something that seniors don’t focus on until they start to lose it or do lose it,” he added. “In my personal experience, when I developed cataracts, I was having great trouble in examining patients and when I had my cataract surgery it revolutionized my ability to practice and to drive.”

“Having good stress management interventions, things like mindfulness-based programs and cognitive behavioral therapy, those can actually reduce recurrent cardiovascular events and may even improve cognitive outcomes,” said Dr. Pakanati. “It’s important to recognize that it’s not just about stress at that exact moment, but chronic stress can also increase your dementia risk.”

“Finding those healthy outlets, whether it’s going on a walk, having mindfulness practices or joining a book club, can help with long-term longevity,” she said. “Whatever practice helps you with your stress management is your own. Whether that’s medication, cognitive behavioral therapy or leaning on the people around you, they’re all important.”

“Moderating alcohol consumption is a big one,” said Dr. Pakanati, noting that there was a “rise during the pandemic as people were at home more with increased access to alcohol. 

“And so while people may drink more as they age, recognizing that alcohol consumption is a risk factor for heart disease and long-term effects on your aging is vital,” she added.

“Physical health is important because it does help with your balance and it helps with building bones and keeping and maintaining some muscle strength,” said Dr. Bope. “Often, falls become a problem for aging people. 

“And, to a degree, you can mitigate that by having good balance, good muscle strength and strong bones,” he added. “We’re not talking about weightlifting or jumping jacks. Just move around a little more by lifting cans of tomatoes, doing some of those everyday activities like lifting your legs, pressing against things. Even simple things can be helpful.”

It’s about “tailoring what patients are able to do. If that’s just going on a walk at first and then eventually doing more, that’s great,” Dr. Pakanati said. “Meeting them where they’re at is really important. Even low intensity activities can have protection for brain health and heart health.”

“A lot of things play a role in healthy aging. Genetics is one of them,” said Dr. Bope. “People do tend to live longer in older families and people also tend to get illnesses based on their family histories such as heart disease and some cancers. Those are things that can be part of your heritage as well as lifestyle choices.” 

But paying attention to family history “gives you an idea of what things to look out for,” he said. “If you’re in a family with history of colon cancer, for instance, you’re hyper aware of that and you don’t dare ignore any symptoms.” 

“Hearing loss is somewhat inherited, and some types of blindness are also inherited,” Dr. Bope explained. “So, all of those things, if they’re in your family you can look for ways to mitigate them, avoid them altogether or deal with them.”

“You have to get into the habit of completely relaxing after you work or other activities because if you have chronic stress, that’s not a healthy lifestyle and it won’t be healthy aging either,” said Dr. Boyer. “That is where developing some recreational activities can help such as reading, going for walks, cooking, knitting, gardening, joining group activities.”

“But it’s hard to develop recreational skills in your eighties and nineties, so that’s why a lot of people do what they did as children,” she said. “In my example, I was raised outside on a farm, so I walked the creeks and now I am walking in my neighborhood.” 

“When doing this, though, you need to be realistic about your expectations and what you are able to do,” said Dr. Boyer. “If you can’t do something, adjust your expectations and find what works for you.”

“The loneliness epidemic is a huge thing going on right now, so it’s important that we remember healthy aging doesn’t just encompass physical health,” said Dr. Pakanati. “Maintaining active participation in the community and making sure that we keep those strong social networks can really help with long-term health outcomes.”

“Social engagement and a sense of purpose are such critical components of healthy aging,” said Dr. Pakanati. “Social connectedness and having a sense of purpose have been linked to reduced risk of cognitive decline, dementia and mortality, as well as an improved overall psychosocial sense of well-being.

“When you feel engaged in your community, when you feel involved in your community, you just feel better and that’ll make you age better,” she added. 

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“The way to get financial stability is to start when you’re very young. It doesn’t matter what you start with or how much you can, just do whatever you can do,” said Dr. Weinstein. “But the time to do it is when you’re young and to obtain some financial literacy.” 

Additionally, “think about who you might designate to manage your financial affairs if you were one day not able to do so for yourself and make sure you talk to that person about what you would want them to do,” said Dr. Boyer. “The same thing goes for health care decisions.”

“The most important thing is you always have time to try to change things but try to change in small increments. Don’t try to change immediately,” said Dr. Weinstein. “For example, if you’re smoking 10 cigarettes today, next week let’s go to eight. Then the following week go to six because some people can’t tolerate stopping cold turkey.”

“You want to have positive feedback for yourself. You want to feel good because if I knew that you smoked 10 a day and now, you’re down to eight, you just did a 20% decrease and that’s fantastic,” he said. “You can also volunteer somewhere or if you’re into sports, do that to improve your quality of life too.

“If you can find something you enjoy, it’s going to make all the difference,” Dr. Weinstein said.

“The biggest thing with healthy aging is recognizing that it’s not just about managing one thing, it’s multifaceted,” said Dr. Pakanati. That is why it is important to have “grace as we age. Things will change and patients will have times where they’re better with things and better with their health and management than others.

“But recognize that much like life in our 20s and 30s, in our 60s and 70s, there will be ebbs and flows in your ability to maintain your health status,” she added. “Having grace with that is really important.”