What should be in a health MOT for over-50s?
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The outgoing head of the NHS, Sir Simon Stevens, has said that a free NHS health check, or “MOT”, will be given to all over-50s as and when they take up the offer of a Covid booster jab in the autumn.
It makes sense. After all, your 50s can be a thoroughly depressing decade. They are, as the actress and comedian Phyliis Diller once said, the decade when everything starts to “wear out, fall out or spread out”.
Sometimes I wonder if it’s an MOT I need or a full service. Like many over-50s, there’s quite a bit of me that needs attention once you lift the bonnet; knees, back, hip – they all give me grief from time to time. Certainly, when you hit 50, the sense of your own mortality really begins to kick in. It did with me. My mum died of a heart attack at 69 while my biological father died from cancer of the throat, aged just 60. I’d be lying if I said their premature deaths didn’t play on my mind. Sometimes, in fact, I wish I could have an MOT every day, just to be on the safe side.
But as the Covid-19 vaccination programme continues to be rolled out across the United Kingdom, the idea that those who are over 50, like me, might also combine any vaccine with a health MOT seems eminently sensible. The theory is that catching any signs of issues like raised cholesterol or high blood pressure early can prevent further complications down the line such as stroke or heart attacks. Indeed, the NHS estimates that at least 300 premature deaths are prevented each year simply because of their health checks.
It should improve attendance rates too, with fewer than half of all eligible people currently taking up their free NHS test. While the health check is largely aimed at preventing the possibility of cardiovascular illnesses, it can also flag up other potential problems like some preventable cancers and respiratory complaints, which often have the same risk factors as heart disease and strokes.
But it won’t pick up those other issues that plague the over-50s. Issues like these…
Eyesight
The most common issue affecting the eyesight of over-50s, including mine, is the inability to see close objects like the small print on packaging or a text message on your phone – especially if it’s one from my kids asking for money. It’s called presbyopia and it’s caused by the lens losing elasticity as you age and, while it’s a condition that usually rears its head in your late 30s or early 40s, it gets worse in your 50s.
And then even worse as you get even older.
But you can slow down the decline. If you smoke then stop, as it has been linked to cataracts and age-related macular degeneration (AMD). Try also to a diet rich in leafy greens, fruit and vegetables and as that will help to reduce the risk of developing AMD.
And don’t forget that when the sun does come out for that one day in what passes for the British summer, be sure to wear sunglasses with a high level of UV protection.
Mental Health
It’s not just your body you have to worry about. It’s estimated that 17 per cent of UK population have depression or anxiety (or a combination of the two) and it’s more than likely you’ll know someone who is living with it. While the symptoms tend to be emotional, it can manifest itself in physical ways too with red flags being extreme fatigue, insomnia, headaches and lack of libido, particularly in the over-50s.
Your lifestyle choices might also reveal more about your condition than you think and if you’re self-medicating with too much alcohol, a poor diet and a sedentary lifestyle, it’s unlikely you’re going to be able to find the way through it. Regular exercise has been proven to be an effective treatment for mild depression, while more serious cases can be treated with anti-depressant medications or, in some cases, Cognitive Behavioural Therapy.
Keep the mind sharp too. As you move into your 40s and on into your 50s, the number of neurotransmitters in the brain dwindles, affecting your ability to retrieve and process information. In 2013, the Advanced Cognitive Training for Independent and Vital Elderly study of individuals over the age of 65 found that consistently engaging in activities like quizzes, puzzles and visual recognition tasks improved the memory in the test subjects, giving weight to the theory that the more you challenge the brain, the more resilient it becomes, even as you get older.
The message is clear: use it or lose it.
Hips
Do you want some more depressing news? Well, from the age of 50, your odds of injuring your hips in a fall double every five years – and women are more than twice as likely to suffer a hip fracture than men. But failing to get help with your hips is one of the main reasons why they continue to be such an issue for the over-50s. According to a study by the Fortius Clinic, 63 per cent of over-50s with hip pain never seek medical help for their pain and, if they do get around to it, they will leave it for an average of 14.5 months before calling their GP. One in 10 sufferers, meanwhile, said their hip pain had also adversely affected their mental health as well.
And the longer you leave it, the more likely that osteoarthritis will set in, especially if you’re overweight or inactive, as Majid Chowdhry, consultant orthopaedic hip and knee surgeon, explains. “By the time people get to their 50s, if they haven't carried over problems in their hip from earlier on in life, they can start to feel pain from early degenerative change,” he says. “The impact from this can be felt as increased stiffness compared to before or difficulties with duration, frequency or intensity of exercise.”
Don’t be backward in coming forward. Get help if your hips hurt.
The knees don’t fare much better . Around 25 per cent of over-50s in the UK suffer from some kind of persistent knee pain, ranging from the more manageable complaints like bursitis through to meniscal tears and more serious issues like osteoarthritis. Again, it’s an age thing. As you get older, the meniscus (the fibrocartilage in your knee joint that acts as a shock absorber) tends to get dehydrated and more rigid and are more easily damaged when put under normal stress.
In both cases, it’s essential you keep those joints moving – it’s what they’re designed to do, after all. Try to keep the surrounding muscles flexible and strong as they will help your joints to move smoothly. You can do this with simple exercises such leg, calf and heel raises, seated knee bends and squats, all of which will strengthen your muscles like your quadriceps, hamstrings and glutes.
But be careful as excessive repetitive impact can damage your joint cartilage. If you’re a runner, for example, make sure you have properly cushioned running shoes and try to run on softer ground, rather than roads or pavements. Alternatively, try cross training machines or “closed chain exercises” where your feet remain planted to the floor or a pedal. They’ll both lessen the impact on your joints. Try other more gentle exercises too, like swimming and walking.
Menopause
As the debate sparked by Davina McCall’s Channel 4 documentary Sex, Myths and the Menopause proved, there is so much that society simply doesn’t get about the menopause. After all, why else would two-thirds of 3,000 women surveyed be offered antidepressants for their menopausal symptoms?
What are those symptoms? How long have you got? There’s mood swings, anxiety, loss of libido, weight gain, panic attacks, joint pain, hair loss, insomnia – the list, like the suffering, goes on and on.
The average age a woman begins the menopause is 51 and there are now estimated to be 4.3 million menopausal women in the country. But there are only 97 specialist menopausal NHS clinics in the UK and only four in Wales, which might explain why one in three women never visit their GP about their menopause.
That has to change. HRT has been proven to help with many of the above problems.
Muscle and bone strengthening
Losing bone strength and density as we age is entirely normal but, according to the NHS, more than three million people in the UK now suffer from osteoporosis and it’s over-50s (and particularly females) that are really susceptible to it, with one in two women breaking a bone because of it.
The reasons are myriad. It could be hereditary or it could be because of a poor diet and lack of exercise. It might be down to having a low body mass index or it could be attributed to other medical conditions or the medications you’re taking. Women, for example, will also lose bone quickly in the initial years after menopause too.
A prolonged lack of calcium in your diet can, over time, reduce the strength of your bones, making them more likely to fracture. Typical breaks include the wrist, the hip and vertebrae and in serious cases even something as innocuous as a sneeze can lead to a broken rib.
But strength training and diet can help to minimise the risk. Resistance training and simple exercises with weights can protect the health of your bones while a calcium and protein-rich diet with lean meats, fish, nuts, leafy vegetables and dairy can help to promote stronger bones.
Diet and weight management
Obesity is nothing short of a national crisis and as competitive eating isn’t yet an Olympic sport, it’s not exactly something we can be proud of. According to The Health Survey for England 2017, the levels of obesity in England have nearly doubled from 15 per cent to 29 per cent since 1993 and it seems the older we get, the bigger we get. Between the ages of 45 to 64, for example, there are now 36 per cent of people classed as obese and 39 per cent defined as overweight.
While the NHS Health Check will measure your height and weight, you shouldn’t really need a qualified medical professional to tell you that you need to diet. If you think you might need to lose weight, try working out your Body Mass Index (BMI). It’s not always the most accurate indicator of a person’s health but it should give you an idea of whether you’re more at risk of developing diseases such as coronary heart disease, Type 2 diabetes or stroke. Simply divide your weight in kilograms by your height in metres squared (there are plenty of BMI calculators online). According to NHS guidelines, a BMI of between 18.5 to 24.9 is considered healthy.
Prioritise eating healthily, in whatever way works best for you. Think about taking up the 80/20 rule; eat healthily 80 per cent of the time, and confine treats to 20 per cent of your time. Use technology to help by measuring steps and calories or sign up for the myriad of online weight loss coaches.
