Healthy Aging

Can brain stimulation devices help improve memory and thinking?

DEAR DOCTOR K: I saw an ad for something called a "tDCS brain-stimulating device." It supposedly helps improve memory and thinking. Is it worth a try?

DEAR READER: Transcranial direct current stimulation (tDCS) transmits a current into the brain through electrodes (little metal plates) on the forehead or scalp. The current is weak; it comes from a 9-volt battery (the size used in a smoke detector). People who undergo tDCS may feel their scalp tingle and hear a humming noise. Doctors can control whether the current activates -- or suppresses -- the neurons in your brain that lie beneath the electrodes.

How can I stay as active as possible as I get older?

DEAR DOCTOR K: I'm in my 80s, and I've lost some mobility over the years. How can I continue to stay as active as possible?

DEAR READER: Most of us take for granted the stamina, strength, balance, coordination and range of motion needed to perform even simple acts such as getting out of bed, heading down the stairs and walking around the block. But when we lose these basic skills, we begin to understand how much of living well relies on being able to move.

Why is it so important we stay hydrated?

DEAR DOCTOR K: I'm in my 80s. At my last checkup, my doctor emphasized how important it is to stay hydrated. Can you explain why?

DEAR READER: Drinking fluids is crucial to staying healthy and maintaining the function of every system in your body. That includes your heart, brain and muscles. Among other things, fluids carry nutrients to your cells. They flush urine and bowel movements, both of which contain body wastes, out of your body. If you don't drink enough fluids, you run the risk of dehydration.

What is it about exercising that promotes good health?

DEAR DOCTOR K: You frequently write that exercising regularly may be the best thing you can do to improve your health. I don't doubt that's true. But have scientists figured out what it is about exercise that promotes health?

DEAR READER: You've asked a very interesting question. Perhaps you're thinking, as do some of my patients, that exercise leads the body to produce certain natural chemicals that promote health. And that if you could make pills out of those health-promoting chemicals, maybe you wouldn't need to exercise. Actually, research here at Harvard in the past few years may have made a step in that direction. The research is primarily in mice, but it probably applies in humans as well.

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.