Healthy Aging

Can osteoporosis medications cause bone fractures?

DEAR DOCTOR K: I'm taking a pill for osteoporosis because my doctor says that stronger bones will reduce my risk of fractures. But a friend recently told me that some osteoporosis medicines actually cause fractures. Can you un-confuse me?

DEAR READER: I know what you're referring to, and it is confusing -- even for doctors. So let me try to make it less confusing. Osteoporosis does make your bones more susceptible to fractures, and a group of drugs called bisphosphonates do successfully treat osteoporosis. These drugs include alendronate (Fosamax), ibandronate (Boniva), risedronate (Actonel) and zoledronic acid (Reclast). People typically remain on these drugs for years.

How can I make a smooth transition into retirement?

DEAR DOCTOR K: I'm thinking of retiring, but I've always had a very busy and fulfilling career. How will I make the transition to retirement? Or should I continue working until I no longer can?

DEAR READER: This might seem like an unusual subject for a doctor writing a column about medical problems, but I get asked this question all the time. Indeed, the decision you make about it might well affect your future health. I'm assuming from your question that you have no financial need to continue working and that your health allows you to do so. Even if it does, there's no doubt that one's energy declines with age. If your work is intense and involves long hours, there will come a time when it's no longer possible to do that work well.

How do I stay healthy as I age?

DEAR DOCTOR K: Can you boil down all of the health advice out there? What do I need to do to age successfully?

DEAR READER: Wow, that's a tall order. Thirty years ago, when I heard people talk about "successful aging," they were talking about avoiding disease and living longer. These days, we want more. Of course we want to live long, disease-free lives. But we also want to be physically fit and functional.

How do I remain motivated to keep up a healthy lifestyle?

DEAR DOCTOR K: Eat right. Don't smoke. Stay active. Can you give me some motivation to keep up these healthy behaviors?

DEAR READER: I think I get your message. This column frequently presents information from scientific studies about healthy lifestyle. But information alone may not be enough to change behavior -- and it's hard to change behavior, particularly when you enjoy it. Information doesn't equal motivation.

Do I need an annual physical if I’m in good health?

DEAR DOCTOR K: I'm 73 and in great health. Do I really need to have an annual physical?

DEAR READER: Let's start by defining "great health." I would define it as having no known chronic (ongoing) illnesses. However, most people your age have at least one chronic illness, such as high blood pressure. People with chronic illnesses need to be checked out at least once a year, and usually more often.Even if they don't have any chronic illnesses, I ask my patients to come in for a checkup every year. That includes asking and answering some questions, a physical examination and some screening tests.

How can I improve or maintain my mobility as I age?

DEAR DOCTOR K: I'm in my 80s. I recently stopped driving, and now I can get around independently only by walking. Can you tell me how to improve, or at least maintain, my mobility?

DEAR READER: Mobility is one of those things most of us take for granted until we begin to lose it. That's when we realize that even a simple, relatively uneventful day requires a great deal of physical stamina, strength, balance, coordination and range of motion. The single most important thing you can do to remain mobile and independent is to engage in regular physical activity. I can't emphasize this enough: You need to be active to stay active.

Should my elderly mother switch to a geriatrician?

DEAR DOCTOR K: My mother has been going to the same doctor for decades. Now that she is 80, should she switch to a geriatrician?

DEAR READER: There's a lot to be said for a doctor-patient relationship that has built trust over the years. Switching to a geriatrician may not be a good idea -- but consulting a geriatrician could be a very good idea. Geriatricians specialize in the health of older adults.

What can my dermatologist do for my wrinkles that’s budget friendly?

DEAR DOCTOR K: I'm in my 60s and already have a lot of wrinkles. What can a dermatologist do for me that will make a difference but not be hugely expensive?

DEAR READER: Age isn't kind to skin. Years of sun exposure leave their mark in the form of fine lines, wrinkles and discoloration. I spoke to my colleague Dr. Kenneth Arndt, clinical professor of dermatology at Harvard-affiliated Beth Israel Deaconess Medical Center.

Why do I have trouble remembering certain types of information but not others?

DEAR DOCTOR K: As I get older, I've noticed that I have more trouble remembering certain types of information. But other types of memory are as strong as ever. Is this true, or just wishful thinking on my part?

DEAR READER: You've made an interesting observation -- and an accurate one. As we age, some information does become harder to recall, and new memories may be harder to lay down in the brain. But other memories remain as accessible as ever.

Is there anyway to reduce the side effects of my osteoporosis drug?

DEAR DOCTOR K: My doctor wants me to take Fosamax for osteoporosis, but the drug gives me heartburn and makes me nauseated. Is there anything I can do to reduce these side effects?

DEAR READER: Fosamax (alendronate) is part of a group of drugs called biphosphonates. Actonel (risedronate) and Boniva (ibandronate) are also in this group. Doctors prescribe biphosphonates to prevent and treat osteoporosis.