A 4-pronged approach to foster healthy aging in older adults
Monitoring patients' health, mobility, mentation, and ability to maintain social connections can help you promote healthy aging for your older patients.
PRACTICE RECOMMENDATIONS
› Prioritize annual wellness visits to improve patient follow-through on recommended services. B
› Encourage physical activity, especially musclestrengthening exercises, to prevent frailty and to mediate decline in the ability to perform activities of daily living. A
› Assess and treat older adults for visual and hearing impairments A , as well as anxiety, depression, and mobility impairments. C They are all associated with cognitive function.
› Ask patients about the frequency of their social interactions A and quality of their relationships B to determine their access to resources, such as food and transportation, as well as their perceptions about their quality of life.
Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
Take a multidimensional approach to healthy aging
Although we have separately examined each of the 4 components of managing healthy aging in a community-dwelling adult, applying a multidimensional approach is most effective. Increasing use of the Medicare AWV provides an opportunity to assess patient health status, determine care preferences, and improve follow-through on preventive screening. It is also important to encourage older adults to engage in regular physical activity—especially muscle-strengthening exercises—and to discuss nutrition and caloric intake to prevent frailty and functional decline.
Assessing and treating vision and hearing impairments and mental health issues, including anxiety and depression, may guard against losses in cognition. When speaking with older adult patients about their social connections, consider asking not only about frequency of contact and access to resources such as food and transportation, but also about whether they are finding ways to bring their own values into those relationships to bolster their QOL. This guidance also may be useful for primary care practices and health care networks when planning future quality-improvement initiatives.
Additional research is needed to support the evidence base for aligning older adult preferences in health care interventions, such as preventive screenings. Also, clinical decision-making requires more clarity about the efficacy of specific diet and exercise interventions for older adults; the impact of early intervention for depression, anxiety, and sleep disorders on neurodegenerative disease; whether loneliness predicts mortality; and how health care delivery systems can be effective at building social connectivity.
For now, it is essential to recognize that initiating health education, screening, and prevention throughout the patient’s lifespan can promote healthy aging outcomes. As family physicians, it is important to capitalize on longitudinal relationships with patients and begin educating younger patients using this multidimensional framework to promote living “a productive and meaningful life”at any age.3
Lynn M. Wilson, DO, 707 Hamilton Street, 8th floor, Department of Family Medicine, Lehigh Valley Health Network, Allentown, PA 18101; lynn_m.wilson@lvhn.org
