The Pocket

Guide to

Staying

Healthy

at 50+

U.S. Department of Health

and Human Services

Agency for Healthcare 

Research and Quality

U.S. Department of Health

and Human Services

Agency for Healthcare

Research and Quality

www.ahrq.gov

AHRQ Pub. No. 04-IP001-A

November 2003

AARP Pub. No. D18010
Contents

Introduction—What’s in This Guide . . . . . . . 1

1.Your Doctors and Nurses—What To Ask

Them and What To Tell Them . . . . . . . . . . . . . . 5

Ask . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Tell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Follow Up. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

2. Staying Healthy—How To Take Charge 

of Your Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Choosing a Healthy Lifestyle. . . . . . . . . . . . . . . 10

Reducing Your Risk for Heart Disease . . . 11

Watching Your Weight. . . . . . . . . . . . . . . . . 12

Eating Right . . . . . . . . . . . . . . . . . . . . . . . . . 12

Keeping Active . . . . . . . . . . . . . . . . . . . . . . . 14

Preventing Skin Cancer. . . . . . . . . . . . . . . . 15

Preventing Injury . . . . . . . . . . . . . . . . . . . . . 16

Taking Medicines Correctly . . . . . . . . . . . . 17

Making Smart Choices About Sexual and 

Reproductive Health . . . . . . . . . . . . . . . . . . . . . 19

Sexually Transmitted Diseases . . . . . . . . . . 20

Planning a Family . . . . . . . . . . . . . . . . . . . . . 21

Menopause and Beyond . . . . . . . . . . . . . . . 22

Overcoming Depression . . . . . . . . . . . . . . . . . 25

Getting Help for Smoking and Alcohol 

or Drug Abuse. . . . . . . . . . . . . . . . . . . . . . . . . . 27

Smoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Alcohol or Drug Abuse . . . . . . . . . . . . . . . 29

3. Checkups,Tests, and Shots—Which Ones

You Need and When To Get Them . . . . . . . . 31

Dental, Hearing, and Vision Care . . . . . . . . . . . 32

Teeth and Gums . . . . . . . . . . . . . . . . . . . . . 33

i
Introduction—What’s in

This Guide

If you are 50 or older, this guide will help you stay

healthy. Here is what is in each section.

1. Your Doctors and Nurses—What To Ask

Them and What To Tell Them. The tips in this

section will help you ask your doctor or nurse the

right questions and get the right answers. You will

see examples of questions throughout the booklet.

Note: Although we refer only to doctors and

nurses here, the information in this booklet applies

to all the health care professionals you consult.

2. Staying Healthy—How To Take Charge of

Your Health. Do you want to lose weight or

exercise more? Are you worried that you may be

depressed? Do you need help to quit smoking?

Learn what to do in your daily life to stay healthy.

3. Checkups,Tests, and Shots—Which Ones

You Need and When To Get Them. Are you

worried about your cholesterol levels? Do you

want to avoid the flu this winter? There are many

checkups, tests, and shots that can help protect your

health. This section will guide you to the ones that

are right for you.

4. More Resources for Good Health—Where

To Get More Information. Are you looking for

more information about a particular disease or

Hearing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

Tests To Find Diseases or Conditions Early. . . 35

High Blood Pressure. . . . . . . . . . . . . . . . . . 35

High Cholesterol. . . . . . . . . . . . . . . . . . . . . 36

Diabetes. . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Osteoporosis. . . . . . . . . . . . . . . . . . . . . . . . 40

Tuberculosis . . . . . . . . . . . . . . . . . . . . . . . . 42

Tests and Exams To Find Cancers . . . . . . . . . . 43

Colorectal Cancer. . . . . . . . . . . . . . . . . . . . 44

Breast Cancer . . . . . . . . . . . . . . . . . . . . . . . 45

Cervical Cancer . . . . . . . . . . . . . . . . . . . . . 46

Prostate Cancer . . . . . . . . . . . . . . . . . . . . . 47

Oral Cancer. . . . . . . . . . . . . . . . . . . . . . . . . 47

Shots To Prevent Diseases . . . . . . . . . . . . . . . . 49

Tetanus-diphtheria Shot . . . . . . . . . . . . . . . 49

Flu Shots . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Pneumonia Shot . . . . . . . . . . . . . . . . . . . . . 50

Hepatitis B Shots . . . . . . . . . . . . . . . . . . . . 50

4. More Resources for Good Health—

Where To Get More Information. . . . . . . . . 51

5. Prevention Charts—How To Keep Track 

of Your Health Care. . . . . . . . . . . . . . . . . . . . 57

Basic Information . . . . . . . . . . . . . . . . . . . . 58

Checkups and Tests Record . . . . . . . . . . . . 60

Cancer Tests Tracker. . . . . . . . . . . . . . . . . . 62

Shots Chart . . . . . . . . . . . . . . . . . . . . . . . . . 64

Medicine Minder . . . . . . . . . . . . . . . . . . . . . 66

ii 1
health problem? This section lists some places to

contact.

5. Prevention Charts—How To Keep Track of

Your Health Care. Do you sometimes forget

when you had your last checkup or what your last

test results were? You can keep track of your health

care by using the prevention charts beginning on

2 3

What Does It Mean To Be at Risk? 

This guide talks a lot about your risk for getting a

disease or a condition and whether you are at risk

for that health problem. Your risk for any disease

or condition depends on whether you have one or

more risk factors. Examples of risk factors include:

Family history. A particular disease or health

problem may run in your family. For example,

diabetes runs in families. Diabetes and its risk factors

are discussed on page 37.

Personal health habits. Sometimes we choose

habits that increase our risk for disease. For

example, smoking is a harmful personal habit. Help

for quitting smoking begins on page 27.

Age. Your age may increase your risk for some

diseases. For example, older men and women are

more likely to get colorectal cancer than those

who are younger. Information on colorectal cancer

starts on page 44.

Sex. Some conditions are more common in

men than in women. Other conditions are more

common in women. For example, women are

more likely than men to suffer from

osteoporosis. Osteoporosis and how to reduce

your risk for it are discussed on page 40.

Race/ethnicity. Some diseases affect people of

one race or ethnic group more than others. For

instance, high blood pressure is more common

among blacks than among whites. How to

control your blood pressure is described on page 35.

Some risk factors you can’t change. You can’t

change your age or your race, for example.

Other risk factors—especially your personal

health habits—you can change. For example,

you can quit smoking or start to exercise

regularly.

To stay healthy, it makes sense to do what you

can to lower your risk for disease. This booklet

can help you lower that risk.

page 57. You may want to bring this booklet with

you when you go to the doctor’s office or clinic.

That way, you can show the staff what tests you have

had, what medicines you take, and other important

information about your health.
Your Doctors 

And Nurses

What To Ask Them and 

What To Tell Them

To stay healthy, you need to feel

comfortable talking with your doctors

and nurses. Here are some tips to help

you feel more comfortable.
Tell

Your health history. Tell your doctors and nurses

about your health history. For example, tell them

about any major diseases or operations you have

had. Be sure to mention family history of diseases

and conditions. For example, if high blood pressure

runs in your family, let your doctor know.

Your health now. Only you know how you feel

and whether you feel differently than you did before.

Tell your doctors and nurses. Also tell them if you

take any medicines, herbs, or supplements such as

vitamins or calcium. And let them know if you are

seeing another doctor or a chiropractor, an

acupuncturist, or any kind of therapist. Don’t

hesitate to report personal information. Feel free to

talk about your beliefs and concerns. You don’t need

to wait to be asked.

The Prevention Charts starting on page 57 can be

helpful when your doctors need to know about

your health history, medicines you are taking, and

what medical tests you may need or have already

had.

Be sure to tell your doctors and nurses if you have

any allergies or reactions to medicines.

Ask

Ask questions. If you don’t understand what your

doctors or nurses say, ask them to explain. Always

ask about any medicines or tests they say you need.

If you don’t ask, they may think you have all the

information you want.

Let your doctors and nurses know if you need more

time to ask questions about your health. If the

doctor doesn’t have time that day, you may be able

to talk to another doctor or nurse, schedule

another appointment, or find out when you can call

later to speak to someone.

Some doctors and health plans have call-in lines. If

you call, you can speak to an advice nurse.

All through this booklet are Ask Your Doctor or

Nurse questions. They are examples of the kinds of

questions you may want to ask.

6 7
Follow Up

Once you leave the doctor’s office, follow up.

• If you have questions, call the doctor’s office.

• If you have problems with your medicine, call

your doctor or your pharmacist.

• If you need to see a specialist or get a test, make

the appointment or ask your doctor’s office to

make the appointment.

• If you do not hear from your doctor or nurse

about test results, call and ask. If you don’t

understand the results, ask what they mean.

8

Staying Healthy

How To Take Charge of 

Your Health

Every day, you have a chance to make

good choices about your health. This

section tells you how.
Choosing a Healthy

Lifestyle

I knew I wanted to lose weight, so I came up

with a plan. I set my goals for a month at a

time. The first month, I decided to trade my

usual high-fat desserts for low-fat yogurt or a

piece of fruit. I also set a goal of walking 30

minutes a day, 4 days a week. As the months

went by, I improved my habits even further. I’ve

lost 7 pounds, and I’m determined to keep

going.

Donna S.

You may ask yourself,“How do I begin to improve

my health habits?” A good way to start is to set

small goals instead of large ones that you won’t be

able to meet. For example, instead of setting a goal

of losing 15 pounds in the next year, set some

smaller goals for eating better and being more

active. You may decide to trade your morning donut

for a bowl of cereal or start taking the stairs instead

of the elevator at work.

10 11

Reducing Your Risk for Heart

Disease

Many of the sections in this booklet have

information to help you reduce your risk for heart

disease. Overall, you can reduce your risk for

heart disease if you:

• Maintain a healthy weight.

• Eat right.

• Stay physically active.

• Quit smoking (see page 27).

• Control your blood pressure and cholesterol

levels (see pages 35 and 36).

• If you have diabetes, control your disease 

(see page 37).

Should You Take Aspirin for a Healthy Heart?

For people who are at high risk for heart disease,

taking aspirin every day or every other day can

help reduce that risk.

For most people, taking aspirin is safe. But for

some, aspirin increases the chance of bleeding in

the stomach or intestines. And there is a small

chance that aspirin will increase your risk for some

kinds of stroke.

Talk to your doctor or nurse to find out if taking

aspirin is right for you.

“

”
Watching Your Weight

Being overweight increases your risk for heart

disease, diabetes, and high blood pressure. Your

doctor can tell you what you should weigh for your

height.

To stay at a healthy weight, you need to balance the

number of calories you eat with the number you

burn off by your activities. You can get to your

healthy weight and stay there by doing two things:

eating right and being physically active. The next two

sections,“Eating Right” and “Keeping Active,” provide

some helpful hints.

Keep track of your weight. Use the Checkups and

Tests Record on page 60.

12 13

Ask your doctor or nurse:

What is a healthy weight for me? 

What are some ways I can control my

weight? 

Eating Right

Eating the right foods and the right amounts can

help you live a longer, healthier life. Many illnesses

and conditions—such as heart disease, obesity, high

blood pressure, and type 2 diabetes—can be

prevented or controlled by eating right. A healthy

diet also provides the vitamins and minerals you

need.

It is never too late to start eating right. Here are

some helpful tips.

Eat a variety of foods, including:

• Vegetables, especially dark-green leafy and

deep-yellow vegetables, such as spinach or

carrots, and legumes, such as lima beans or 

green peas.

• Fruits,such as melons, berries, and citrus fruits,

or juices, such as orange or grapefruit.

• Meat, poultry, eggs, fish, and dried beans (for

example, navy, kidney, or black), especially

products low in fat, such as lean meat and poultry

prepared without skin.

• Dairy products,such as milk, yogurt, and

cheese, especially low-fat or fat-free dairy

products.

• Grains, especially whole grains, such as oatmeal

or whole grain breads.

Limit calories and saturated fat.

Foods high in saturated fats are high in calories, so

they can cause weight gain. They also increase your

cholesterol levels.Try to limit:

• High-fat dairy products such as ice cream, butter,

cheese, cream, and whole milk.
• Meats high in fat, such as bacon or chicken with

the skin on.

• Palm and coconut oils and lard.

Unsaturated fats do not raise cholesterol levels.

Foods with unsaturated fat include vegetable oils,

fish, avocados, and many nuts.

Watch portion sizes.

Don’t choose “super” or other oversized portions.

Be aware of how much you eat.

Keeping Active

Physical activity can help prevent:

• Heart disease.

• Obesity.

• High blood pressure.

• Type 2 diabetes.

• Osteoporosis (thinning bones).

• Mental health problems, such as depression.

Physical activity also helps you stay at a healthy

weight, reduce stress, sleep better, and feel better

overall.

What To Do

All kinds of physical activity, whether it is moderate

or vigorous, will help you stay healthy. It’s a good

idea to aim for at least moderate activity—such as

brisk walking, raking leaves, or house cleaning—for

14 15

30 minutes most days of the week. Generally, the

more active you are, the healthier you will become.

How To Get Started and Keep at It

If you have not been active, start slowly.

Choose something that fits into your daily 

life.

Choose an activity you like, or try a new one.

Activities such as dancing, swimming, or biking can

be fun.

Ask a friend to exercise with you, or join a group.

Make time in your day for physical activity.

If the weather is bad, try an exercise show on TV,

watch an exercise tape, walk in the mall, or work

around the house.

Ask your doctor or nurse:

How do I get started with an exercise

program? 

Preventing Skin Cancer 

Skin cancer is often preventable.

You can lower your risk for skin cancer by:

• Limiting the time you spend in the sun, especially

between the hours of 10 a.m. and 3 p.m.
• Wearing sunglasses and clothing that protects

against the sun—such as broad-brimmed hats,

long-sleeved shirts, and long pants—when you

are in the sun.

• Using sunscreen when you are in the sun. (But,

don’t stay out in the sun longer just because you

are wearing sunscreen.)

Preventing Injury

Following basic safety rules can prevent many

serious injuries. Here are two checklists to follow to

help keep you and your family safe.

To help protect yourself at home:

• Use smoke detectors. Remember to check the

batteries every month. Change the batteries

every year. You may want to use a reminder. For

example, change the batteries around your

birthday or some holiday.

• Lock up guns and ammunition, and store them

separately.

• Keep hallways and stairwells well lit.

• Remove or repair things that someone could trip

on, such as loose rugs, electrical cords, and toys.

To help protect yourself away from home:

• Wear seat belts.

• Never drive after drinking alcohol.

• Always wear a safety helmet while riding a

motorcycle or bicycle.

16 17

• Be alert for hazards in your workplace. Follow

workplace safety rules.

Taking Medicines Correctly

Always be sure you know everything about a

medicine before you take it. This information will

help you get the full benefits from your medicine. It

will also help you avoid taking too much or too little

of a medicine. Taking medicine in the wrong way can

make you worse instead of better.

Ask your doctor, nurse, or pharmacist:

What is the name of the medicine? Is

there a generic form of this medicine? If

so, should I consider it?

What is the medicine supposed to do? 

How often and when do I take it—and for

how long? 

Are there any foods, drinks, other

medicines, dietary supplements, or

activities I should avoid while taking this

medicine? 

What are the possible side effects? 

What should I do if they occur? 

When should I see an improvement?

What written information is available

about the medicine? 
Making Smart Choices

About Sexual and

Reproductive Health

As I got closer to menopause, I worried about

all the changes my body was going through. But

after I talked to my doctor, I realized it was all

perfectly normal. She had good advice for

relieving symptoms, too.

Lucy S.

This section offers information about sexually

transmitted diseases and birth control. There are

also tips for women about what to expect during

and after menopause.

18 19

To keep track of the medicines you are taking, fill in

the Medicine Minder on p. 66. You may want to

bring the chart with you when you go to your

doctor, nurse, or pharmacist.

Your Medicine: Play It Safe (AHRQ Publication 

No. 03-0019) gives practical tips on how to take

medicines safely. To get a copy, call the Agency for

Healthcare Research and Quality (AHRQ)

Publications Clearinghouse at 1-800-358-9295 

or e-mail at ahrqpubs@ahrq.gov.

“

”
Sexually Transmitted Diseases 

Sexually transmitted diseases (STDs), such as HIV

infection, herpes, syphilis, gonorrhea, chlamydia, and

hepatitis B, are passed easily from one person to

another during sex.

Sexually transmitted diseases may cause serious

health problems. For example, HIV causes AIDS.

Hepatitis B can cause liver damage, including liver

cancer.

If you have sex, you may be at risk for a

sexually transmitted disease. Your risk is

increased if:

• You or your partner has or had other sexual

partners.

• You do not use condoms consistently and

correctly.

• Your partner has a sexually transmitted disease.

• You use injection drugs.

• You exchange sex for money or drugs.

• You live in an area where a particular sexually

transmitted disease is common.

• You are a man and have sex with other men.

If you are at increased risk, talk to your doctor

about whether you should be tested. This is

especially important because serious health

problems may develop before you realize you have a

disease.

20 21

You can greatly lower your risk for sexually

transmitted diseases by using a male latex condom

every time you have sex. If you are allergic to latex,

use a polyurethane (soft plastic) or synthetic

condom.

Planning a Family

If you have sex and are not planning to have a child,

you and your partner may want to use some form

of birth control. Many birth control methods are

available for men and women. Each has advantages

and disadvantages.

The condom is the only birth control method

that protects against most STDs, including

HIV/AIDS.

Whichever birth control method you choose,

remember that, for it to work, you must use it all

the time and use it correctly.

Ask your doctor or nurse:

Which method of birth control is best for

me?
If you have not had a period for at least a year, you

are likely to be in menopause. At this point, your

hormone levels drop, so you are no longer

producing eggs. Once this happens, there is no

chance of becoming pregnant.

What happens after menopause? 

Women are at higher risk than before menopause

for some diseases, such as osteoporosis (bone

thinning, which causes bones to break easily). Their

bodies no longer make the estrogen that may help

protect them against such diseases. (For more

information on osteoporosis, see page 40.) 

Some women also continue to have symptoms such

as hot flashes and vaginal dryness.

Hormone Therapy. Hormone therapy increases

the levels of the hormones estrogen, progesterone,

or both in your body. If you are approaching

menopause or have gone through menopause, you

may be considering hormone therapy to relieve

symptoms of menopause or to reduce your risk for

diseases such as osteoporosis.

Hormone therapy may reduce your risk for fracture,

bone thinning, and colorectal cancer. On the other

hand, some hormone therapies may increase your

risk for breast cancer, heart disease, blood clots,

stroke, and gall bladder disease. For women with

mild or no symptoms of menopause, the potential

harms of hormone therapy may outweigh the

benefits.

22 23

Menopause and Beyond

The time when a woman’s menstrual cycle stops for

good is called menopause. Most women reach

menopause in their late 40s or early 50s.

During the years leading up to menopause, levels of

two female hormones, estrogen and progesterone,

begin to change. These changes signal that your

body is getting ready to stop menstruating. This time

leading up to menopause is called perimenopause.

Perimenopause usually lasts from 5 to 7 years. You

can still get pregnant during this time, so you may

want to use some method of birth control.

Most women have begun perimenopause by the

time they are 50 years old. Some may have reached

menopause by then.

For many women, the shifting levels of hormones

during perimenopause cause physical and emotional

changes. Some of these changes may be

uncomfortable, but there are many ways to relieve

the discomfort.

The changes could include any of the

following:

• Skipped periods.

• Irregular bleeding.

• Hot flashes.

• Mood swings.

• Sleep problems.

• Painful intercourse from vaginal dryness.
Overcoming Depression 

I started making excuses to avoid social

occasions. I guess I knew something was wrong,

but I felt too low to do anything about it. Luckily,

my daughter pushed me to talk to my doctor

about depression. The doctor recommended

counseling and trying some medicines. Now it’s

hard to believe how depressed I was. I feel

relieved every day.

Rodney F.

Everybody feels “down” or “blue” sometimes. But, if

these feelings are very strong or last for most of the

day nearly every day for 2 weeks or longer, they may

be due to a medical illness called depression.

The good news is that depression can be treated.

You do not have to face this problem without help.

Here are some warning signs of depression.

Changes in the way you feel:

• You feel sad, hopeless, or guilty most of the time.

If you are considering hormone therapy, it is

important to be well informed about these benefits

and harms and how they apply to you specifically.

Your doctor can help you decide whether hormone

therapy is right for you.

For more information about menopause and

hormones, visit the U.S. Food and Drug

Administration’s Menopause and Hormones Web

site at: http://www.fda.gov/womens/menopause/.

Information is available in English and Spanish.

24 25

Ask your doctor or nurse:

How can I relieve the symptoms of

perimenopause and menopause?

Is taking hormones right for me? 

If so, how long can I take hormones safely?

“

”
Getting Help for Smoking

and Alcohol or Drug Abuse

I tried at least half a dozen times before I quit

smoking for good. This time, I think I’ve licked it.

But I know I have to be careful. Even after 6

months, I stay away from places where people

are smoking.

Jeff H.

Smoking

More than 430,000 Americans die each year from

smoking. Smoking causes illnesses such as cancer,

heart and lung disease, and stroke. When you quit,

you lower your chances of getting sick from

smoking. Quitting is hard. Most people try several

times before they quit for good.

When you are getting ready to quit:

• Make a plan and set a quit date.

• You feel tired or lack energy.

• You have thoughts of suicide or death.

Changes in sleeping and eating habits:

• You sleep either too much or too little.

• Your appetite has changed. You have gained or

lost weight.

Changes in daily living:

• You have lost interest and pleasure in daily

activities.

• You have problems making decisions or thinking

clearly.

If you have had most of these symptoms for at least

2 weeks, you may be suffering from depression.Talk

to your doctor about whether you are depressed

and what you should do about it.

The sooner you get treatment for depression, the

sooner you will begin to feel better. The longer you

wait, the harder depression is to treat.

Depression usually is treated with counseling,

medicine, or both. Medicines for depression are not

addicting or habit forming. They work for people

with severe depression and may be useful for people

with mild to moderate depression.

Treatment works gradually over several weeks. If

you do not start to feel better after this time, tell

your doctor. It may take some time to find what

works best for you.

26 27

“

”
• Tell your doctor that you want to quit smoking,

and get medicine to help you quit.

• Tell your family, friends, and people you work with

that you are going to quit. Ask for their support.

When you quit:

• Get support and encouragement. You may want to

join a quit-smoking program.

• If you slip and smoke, don’t give up. Set a new

date to get back on track.

• After you quit, don’t smoke—not even a puff. Try

to keep yourself away from all cigarettes.

The following tools from the U. S. Public Health

Service can help you quit smoking:

• You Can Quit Smoking Consumer Guide. This easyto-read, 12-page booklet tells you how to get help

to quit smoking.

• Good Information for Smokers. This mini-flip booklet

tells you why and how to quit smoking.

• You Can Quit Smoking 5-day Countdown. This 12-

page booklet gives helpful tips for what to do on

each of the 5 days before you quit.

• You Can Quit Smoking Pocket Card. This carry-itwith-you card sums up the four steps to quitting

and includes a toll-free help number.

To get free copies, call the AHRQ Publications

Clearinghouse at 1-800-358-9295 or e-mail

ahrqpubs@ahrq.gov.

28 29

Do You Have a Drinking Problem?

Ask yourself the questions below. A “yes” answer

to any of them may be a sign that you have a

drinking problem. Alcohol abuse and alcoholism

are treatable with counseling, medicines, or both.

Talk to your doctor or nurse.

Have you ever felt that you should cut down on

your drinking? 

Have people annoyed you by criticizing your

drinking? 

Have you ever felt bad or guilty about drinking?

Have you ever had a drink first thing in the

morning to steady your nerves or to get rid of a

hangover? 

Drug use can cause heart and breathing problems.

Alcohol abuse can cause liver disease, heart

problems, and several kinds of cancer.

Here are some suggestions about drugs and

alcohol:

• Don’t use illegal (street) drugs of any kind, ever.

Alcohol or Drug Abuse

Abusing alcohol or drugs can cause serious medical

and personal problems. Alcohol and drug abuse can

lead to accidents, depression, and problems with

friends, family, and work.
30

Checkups,Tests,

and Shots

Which Ones You Need and

When To Get Them

Checkups and tests, such as vision tests

or cholesterol tests, help find diseases or

conditions early, when they are easier to

treat. Shots (immunizations) protect you

from different diseases.

This section gives you information on

why and when you may need different

checkups, tests, and shots.

• If you drink alcohol, limit the amount—no more

than one drink a day for women and two drinks

a day for men. One drink equals a 12-ounce

bottle of beer or wine cooler, a 5-ounce glass of

wine, or 1.5 ounces of 80-proof distilled spirits,

such as gin, whiskey, or rum.

• Don’t drink alcohol before driving or operating

heavy machinery.
Teeth and Gums

Here are some simple tips to follow for

dental health:

• Visit your dentist once or twice a year for

checkups.

• Brush after meals with a toothbrush that has soft

or medium bristles.

• Use toothpaste with fluoride.

• Use dental floss every day.

• Eat fewer sweets, especially between meals.

• Don’t smoke or chew tobacco products.

Hearing

Hearing loss is one of the most common health

problems. Your risk for hearing loss increases after

age 50.

How can you tell if you have a hearing

problem? Here are some signs:

• You may have to strain to hear a normal

conversation.

• You may find yourself turning up the volume of

the TV and radio so loud that others complain.

If you are worried about your hearing, talk to your

doctor or nurse. They may suggest a hearing test.

Hearing aids can help you hear well.

Dental, Hearing, and Vision

Care

I keep better track of when my pets need their

checkups than when I need checkups myself. I

can’t seem to remember the next time I need

to visit the dentist or get my eyes checked. So

I’ve started to ask my dentist and doctor when I

need my next appointment. I write it down in

my Pocket Guide to Staying Healthy at 50+.

Narong P.

Getting the checkups you need for your teeth and

gums, vision, and hearing is an important part of

your health care. This section tells you how to take

care of your teeth and gums and can help you

decide whether you need your hearing and vision

checked. Keep track of these checkups with your

Checkups and Tests Record on page 60.

32 33

“

”
Tests To Find Diseases or

Conditions Early

Last year, my doctor told me I had high

cholesterol. The doctor said to eat the right

foods, lose weight, and exercise. I was worried

about having a heart attack, but I didn’t know

where to begin. So I went back to my doctor

and talked with her about a plan for taking

better care of myself.

Marietta S.

Many diseases and conditions can be prevented or

controlled if they are caught early. This section will

help you decide what tests you need and how often

you need them. You can keep track of the tests with

your Checkups and Tests Record on page 60.

High Blood Pressure

High blood pressure can lead to heart disease,

stroke, and kidney disease. It is most common in

black people and people older than 45.

Vision

You may have more vision problems—such as

glaucoma, cataracts, or macular degeneration—now

than when you were younger. Also, older people are

more likely than younger people to suffer accidental

injuries because of vision problems. By age 65, you

should have regular eye exams.

34 35

What Is Glaucoma, and Should You Be Tested

for It? 

Glaucoma can lead to vision problems and even

cause blindness. Your risk for glaucoma increases as

you age.

Early treatment—with medicine, surgery, or both—

can prevent or delay the serious vision problems

caused by glaucoma.

You are more likely to get glaucoma, and you should

see an eye doctor for a glaucoma test, if:

• You are severely near-sighted.

• You have diabetes.

• You have a family history of glaucoma.

• You are older than 65 or older than 40 and black.

“

”

Eyeglasses or contact lenses can improve your

vision. Doctors also have other ways to protect and

improve your vision. Be sure to tell your doctor if

you have trouble with your vision.
As a person 50 or older, you should have your

cholesterol checked. Most experts recommend

checking it every 5 years. Your doctor or nurse may

suggest you have it checked more often, especially if

your cholesterol is too high.

Eating a healthy diet and being active are two ways

you can keep your blood pressure under control.

(See “Eating Right” on page 12 and “Keeping Active”

on page 14.)

Some people need to take medicine to keep their

blood pressure at healthy levels. If you take

medicine, be sure to talk to your doctor about how

to take it. Do not skip any doses of medicine.

36 37

Ask your doctor or nurse:

What should my blood pressure be? 

How often should I have my blood pressure

checked?

If I have high blood pressure, what can I do

to lower it?

High Cholesterol

Too much cholesterol can clog your blood vessels

and is a major cause of heart disease.

To help lower your cholesterol and keep it at a

healthy level, eat the right foods, maintain a healthy

weight, and be physically active. (For more

information, see the sections “Eating Right” on

page 12 and “Keeping Active” on page 14.) Your

doctor or nurse may suggest you take medicine to

lower your cholesterol.

Ask your doctor or nurse:

How often should I have my cholesterol

checked? 

What is a healthy cholesterol level for me? 

If I have high cholesterol, what can I do to

lower it?

Diabetes

Diabetes, or high blood sugar, is a major cause of

blindness, kidney disease, high blood pressure,

stroke, heart disease, and amputation of the lower

legs and feet. Almost all adults who have diabetes

have type 2 diabetes.This type usually appears in

middle age. The number of people in the United

States who have type 2 diabetes is growing.

Exercise, a healthy diet, and watching your weight

can lower your chances of getting type 2 diabetes.

If you already have diabetes, those health habits

and quitting smoking can help you prevent or

control many of the problems of diabetes.
Your risk for type 2 diabetes increases as you get

older. In the United States, almost one in five people

between the ages of 65 and 74 has diabetes.

Your risk for type 2 diabetes also is higher

than average if:

• You are American Indian, Alaska Native, Hispanic,

or black.

• You have a family member with diabetes.

• You are overweight.

• You had diabetes during pregnancy.

You may want to be tested for diabetes if you have

high blood pressure or high cholesterol. If you have

diabetes, you may need to maintain lower blood

pressure and cholesterol levels than you would if

you did not have diabetes.

38 39

Ask your doctor or nurse:

If you are at risk for diabetes, have high

blood pressure, or have high cholesterol:

Should I be tested for diabetes?

If you learn that you have diabetes:

When and how often do I need:

• Eye and dental exams? 

• Blood pressure and cholesterol 

checks? 

• Blood sugar checks?

• Flu shots? 

Should I take medicines for my 

diabetes? If so, how much should I take 

and when? 

What is the right weight for me? 

What kinds and amounts of food are 

right for me? 

How should I take care of my feet? 

If you smoke:

What can I do that will help me stop 

smoking? (For more information about 

quitting smoking, see “Smoking” 

beginning on page 27.) 
• Not smoking.

• Taking medicines that can help prevent

osteoporosis.

Osteoporosis

Osteoporosis, or thinning bones, makes your bones

break easily. This condition is more common in

women than in men. After women have gone

through menopause, their bodies make less estrogen

(a hormone that helps protect their bones). Their

bones become more prone to breaking.

Half of all women past menopause will break a bone

during their lives. A bone density test can help

determine whether your bones are prone to

breaking. If they are prone to breaking, your doctor

may suggest that you take a medicine to reduce

your risk for fractures.

Women who are 65 or older should be tested

regularly for osteoporosis. You should begin to be

tested at age 60 if you are at increased risk for

fractures, for example, if you weigh less than 155

pounds.

You can reduce your risk for osteoporosis by:

• Doing weight-bearing exercises, such as walking,

climbing stairs, jogging, yoga, and lifting weights.

• Getting 1,000 to 1,300 milligrams of calcium

every day by eating the right foods (see “Which

Foods Are High in Calcium?” at right.) A cup of

milk or plain yogurt has 300 milligrams of

calcium. You can also take calcium pills with

vitamin D if you are not getting enough calcium

in the food you eat.

40 41

Ask your doctor or nurse:

How can I get enough calcium? 

Should I have a bone density test? If so,

how often should I have this test?

What medicines can help prevent

osteoporosis? Should I take them? 

Which Foods Are High in Calcium?

Foods in the milk group, such as milk and dishes

made with milk, cheese, and yogurt. (Choose

lower fat, lower cholesterol foods, such as skim

milk.)

Canned fish with soft bones, such as sardines,

anchovies, and salmon.

Dark-green leafy vegetables, such as kale, mustard

greens, turnip greens, and spinach.

Tofu, if it is processed with calcium sulfate. Read

the label to find out.

Tortillas, if they are made from lime-processed

corn. Read the label to find out.
Tests and Exams To Find

Cancers

I knew many of my friends were getting

mammograms. But I didn’t think it was very

important because no one in my family ever

had breast cancer. Then a good friend of mine

was diagnosed with breast cancer, and she had

no family history of it. So I decided to ask my

doctor about the testing. She told me that all

women 40 and older need a mammogram

every year or two.

Anita T.

You can increase your chances of finding a cancer

before it has spread by getting certain screening

tests and exams regularly. Many cancers can be

treated more easily when they are found early.

The tests you get and how often you get them will

depend on your age, health history, and risk factors,

such as family history and lifestyle.

Tuberculosis

Tuberculosis (TB) is an infection that affects the

lungs and eventually other parts of the body. This

infection can be passed from one person to the

next. It is treated more easily if caught early.

You are at greater risk for TB and may need a

TB test if:

• You have been in close contact with someone

who has TB.

• You have recently moved from Asia, Africa,

Central or South America, or the Pacific Islands.

• You have kidney failure, diabetes, HIV, or

alcoholism.

• You have injected or now inject street drugs.

42 43

“

”
Breast Cancer 

Breast cancer is the most common cancer among

women in the United States.

This section gives you some guidelines about what

tests you may need to find certain cancers. You can

keep track of cancer tests you have had by using the

Cancer Tests Tracker on page 62.

Colorectal Cancer

Colorectal cancer is second only to lung cancer as a

cause of death from cancer. But if colorectal cancer

is caught early, it can be treated.

Older men and women are more likely to get

colorectal cancer than those who are younger.

Starting at age 50, you should be tested for

colorectal cancer. Tell your doctor if you have had

polyps or if you have family members who have had

colorectal cancer, breast cancer, or cancer of the

ovaries or uterus. If so, you may need to be tested

more often and at an earlier age.

There are a number of effective tests, used

separately or together, for colorectal cancer. Each

has advantages and disadvantages.

44 45

Ask your doctor or nurse:

Which test or tests for colorectal cancer

would be best for me?

How often should I get tested?

Ask your doctor or nurse:

Should I have a mammogram? If so, how

often?

Should You Take Medicines To Reduce Your

Risk for Breast Cancer?

If you are at high risk for breast cancer, talk with

your doctor about whether you should take

medicine to reduce your risk. While medicines can

reduce some women’s risk for breast cancer, they

also may cause blood clots and cancer of the

uterus.

Women 50 or older are at higher risk for breast

cancer than are younger women. If you have a sister

or mother who has had breast cancer, your risk is

even higher. A mammogram every 1-2 years can

help find this disease early when it is easier to treat.

Mammograms have a few risks. They may not find

all breast cancers. Also, they may show that you

have cancer when you really do not. These falsepositive results could lead to unnecessary biopsies.
Prostate Cancer

Prostate cancer is most common in men older than

50.

Your risk may be increased if:

• You are black.

• Your father or brother has had prostate cancer.

Tests such as a PSA (prostate-specific antigen) blood

test or a digital rectal exam can help detect prostate

cancer, but these tests also have risks. They

sometimes have false positive results, which may lead

to avoidable anxiety and unnecessary biopsies and

treatment. It is not yet clear whether these tests

save lives.

Cervical Cancer

All women who are or have been sexually active are

at risk for cancer of the cervix, unless their uterus

has been completely removed. Most deaths from

cancer of the cervix can be prevented if the cancer

is found and treated early. A Pap test is used to find

cervical cancer.

Women need to have a Pap test at least every 3

years, and women at increased risk for cervical

cancer may need the test more often.

You are at increased risk for cervical cancer

if:

• You have had a sexually transmitted disease.

• You have had more than one sex partner.

• You have had abnormal Pap tests.

Your doctor may suggest stopping Pap tests

if:

• You are older than 65, have had regular, normal

Pap tests, and are not at increased risk for other

reasons.

• You have had a hysterectomy.

46 47

Ask your doctor or nurse:

Do I still need a Pap test? If so, how often?

Ask your doctor or nurse:

Should I be tested for prostate cancer?

Oral Cancer 

Oral cancer includes cancers of the lip, tongue,

pharynx, and mouth. Most oral cancers occur in

people older than 40 who use tobacco or alcohol.

People who are in the sun a lot are at risk for

cancer of the lip.

You can help prevent oral cancer by not smoking

or abusing alcohol. If you are outdoors a lot, use a

sun block on your lips.
Shots To Prevent Diseases

I watched some of my relatives suffer with

pneumonia and just hoped it would never happen

to me. Then I found out about the pneumonia

shot. I got one last year, and now I feel much

safer. I tell all my friends and relatives to get the

shot.

Belle T.

You can prevent some serious diseases by getting

shots (immunizations). This section tells you which

shots you need and when. Keep track of the shots

you receive. Use the Shots Chart on page 64.

Tetanus-diphtheria Shot

Most people need this shot every 10 years.

If you chew or smoke tobacco or abuse alcohol, you

may want your dentist to examine your mouth for

signs of oral cancer during your regular dental

checkup. You also may need to see your dentist

more often.

48 49

Ask your doctor, dentist, or nurse:

How often should I get dental checkups?

“

”
50

More Resources

for Good

Health

Where to Get More

Information

To learn more about staying healthy and

preventing disease, you can contact the

organizations listed in this section. You

can get free information by calling or

checking the Web sites.

Flu Shots

People 50 or older need a flu shot every year.

Pneumonia Shot

Everyone needs a pneumonia shot once around age

65. If you have lung, heart, or kidney disease;

diabetes; HIV; or cancer, you may need this shot

sooner.

Hepatitis B Shots

You should receive hepatitis B shots if:

• You have had sex with more than one partner or

with someone infected with hepatitis B.

• You are a man and have had sex with another

man.

• You have had any other sexually transmitted

disease within the last 6 months.

• You have injected street drugs.

• You have a job that involves contact with human

blood or blood products.

• You travel to areas where hepatitis B is common.

Ask your doctor or nurse:

Which shots are right for me?

When should I get them?
Alcohol and Drug

Abuse

National Clearinghouse

for Alcohol and Drug

Information

Substance Abuse and

Mental Health Services

Administration

U.S. Department of Health

and Human Services 

1-800-729-6686

http://www.health.org

National Institute on

Alcohol Abuse and

Alcoholism 

National Institutes 

of Health 

U.S. Department of Health

and Human Services

301-443-3860

http://www.niaaa.nih.gov

National Institute on Drug

Abuse

National Institutes of

Health

U.S. Department of Health

and Human Services

301-443-1124

http://www.drugabuse.gov

Cancer

Cancer Information Service 

National Cancer Institute

National Institutes of

Health

U.S. Department of Health

and Human Services

1-800-422-6237

1-800-332-8615 (TTY) 

http://www.cancer.gov

Depression

National Institute of

Mental Health

National Institutes of

Health

U.S. Department of Health

and Human Services

301-443-4513

http://www.nimh.nih.gov/

publicat/depressionmenu.

cfm

53

General Health

Information

Agency for Healthcare

Research and Quality

Publications Clearinghouse

U.S. Department of Health

and Human Services

1-800-358-9295 

http://www.ahrq.gov

Centers for Disease

Control and Prevention

U.S. Department of Health

and Human Services

http://www.cdc.gov/health

healthfinder®

(Provides electronic

information on a wide

variety of health topics.

This site can direct you to

medical journals and 

other publications,

clearinghouses, databases,

hot lines, medical

research, support groups,

organizations, and

libraries.)

http://www.healthfinder.gov

National Women’s Health

Information Center

U.S. Department of Health

and Human Services 

1-800-994-9662 

http://www.4women.gov

Aging

AARP 

1-800-424-3410

http://www.aarp.org 

Administration on Aging

U.S. Department of Health

and Human Services

202-619-0724

http://www.aoa.gov

National Institute on Aging

National Institutes of

Health

U.S. Department of Health

and Human Services

301-496-1752

http://www.nia.nih.gov 

52
Mental Health 

National Institute of

Mental Health

National Institutes of

Health

U.S. Department of Health

and Human Services

301-443-4513

301-443-8431 (TTY)

http://www.nimh.nih.gov 

Nutrition

Center for Food Safety

and Applied Nutrition 

U.S. Food and Drug

Administration

U.S. Department of Health

and Human Services

1-888-463-6332

http://www.fda.gov

Osteoporosis

Osteoporosis and Related

Bone Diseases

National Resource Center

National Institutes of

Health

U.S. Department of Health

and Human Services

1-800-624-2663

202-466-4315 (TTY)

http://www.osteo.org

Safety and Injury

Prevention

U.S. Consumer Product

Safety Commission

1-800-638-2772

http://www.cpsc.gov

Sexually Transmitted

Diseases (STDs) and

AIDS

Centers for Disease

Control and Prevention

(CDC) 

U.S. Department of Health

and Human Services 

CDC National HIV, AIDS,

& STD Hotline

1-800-342-2437 

1-800-243-7889 (TTY)

CDC National Prevention

Information Network

1-800-458-5231

1-800-243-7012 (TTY)

http://www.cdcnpin.org

Diabetes

Lower Extremity

Amputation Prevention

Program

Bureau of Primary Health

Care

Health Resources and

Services Administration

U.S. Department of Health

and Human Services

1-888-275-4772 

http://www.bphc.hrsa.

gov/leap

National Institute of

Diabetes and Digestive

and Kidney Diseases

National Institutes of

Health

U.S. Department of Health

and Human Services

301-496-3583

http://www.niddk.nih.gov 

Health Care Coverage

Agency for Healthcare

Research and Quality

U.S. Department of Health

and Human Services

1-800-358-9295

http://www.ahrq.gov/

consumer/insuranc.htm 

Administration on Aging

State Health Insurance

Assistance Program

U.S. Department of Health

and Human Services

202-619-0724

http://www.aoa.dhhs.gov/

eldfam/elder_rights/health_

counseling/health_

counseling.asp 

Hearing 

National Institute on

Deafness and Other

Communication Disorders

National Institutes of

Health

U.S. Department of Health

and Human Services

1-800-241-1044 

1-800-241-1055 (TTY)

http://www.nidcd.nih.gov 

Heart, Lung, and Blood

Diseases 

Information Center

National Heart, Lung, and

Blood Institute

National Institutes of

Health 

U.S. Department of Health

and Human Services

301-592-8573

240-629-3255 (TTY)

http://www.nhlbi.nih.gov 

54 55
Smoking

Cancer Information

Service 

National Cancer Institute

National Institutes of

Health

U.S. Department of Health

and Human Services

1-800-422-6237 

1-800-332-8615 (TTY) 

http://www.cancer.gov

Stroke

National Institute of

Neurological Disorders

and Stroke

National Institutes of

Health 

U.S. Department of Health

and Human Services

1-800-352-9424

http://www.ninds.nih.gov 

Urinary Problems

National Institute of

Diabetes and Digestive

and Kidney Diseases

National Institutes of

Health 

U.S. Department of Health

and Human Services

301-496-3583

http://www.niddk.nih.gov

Vision

National Eye Institute

National Institutes of

Health

U.S. Department of Health

and Human Services

301-496-5248 

http://www.nei.nih.gov

56

Prevention

Charts

How To Keep Track of Your

Health Care

The charts in this section can make it

easier to keep track of your health. Ask

your doctor or nurse how often you

need each type of care and when. Then

write down the information in the charts

here. Also, write down the date and

results of the care you get or ask your

doctor to write down this information.

Bring this guide with you each time you

see a doctor or nurse. That way, you can

update your Prevention Charts right

away.
Basic Information

Name: ____________________________________

Address: ___________________________________

__________________________________________

__________________________________________

__________________________________________

Telephone: _________________________________

__________________________________________

Emergency Contact: _________________________

__________________________________________

__________________________________________

__________________________________________

Allergies: __________________________________

__________________________________________

__________________________________________

Past Illnesses or Operations: ___________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

58

Doctors’ Names and Phone Number(s): _________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

__________________________________________

Medical Insurance Company and Number(s): ______

__________________________________________

__________________________________________

__________________________________________

__________________________________________

59
Checkups and Tests Record

Use this record to write down the date you receive

the tests and the results. Try to remember to bring

the booklet with you each time you see a doctor.

60 61

Blood Pressure

Blood Sugar

Bone Density 

Cholesterol 

Dental Visits 

Hearing 

Tuberculosis

Vision

Weight

Checkup/Test Date/Results

This record will also help you keep track of when

you need your next test or checkup.
Colorectal Cancer

Test

Mammogram

Oral Cancer Exam

Pap Test

Prostate Cancer

Test/Exam

Cancer Tests Tracker

62 63

Type of Test/Exam Date/Results
Tetanus-Diphtheria Every 10 years

Flu Every year after 

age 50 or sooner 

if at risk 

(see p. 50.)

Pneumonia Once at age 65

or sooner if at

risk (see p. 50.)

Hepatitis B If at risk

(see p. 50.)

Shots Chart

64 65

Immunization (Shot) How Often Date(s) Received
Medicine Minder

Write down the name of each medicine you take,

the reason you take it, and when you start and stop

in the spaces below. Add new medicines when you

66 67

Name of Medicine Reason Taken Date Started Date Stopped

get them. You can show the list to your doctor and

pharmacist. You may want to make copies of the

blank form so you can use it again.
69

NOTES NOTES

68
The U.S. Preventive Services Task Force (USPSTF)

continuously updates its recommendations on clinical

preventive services and makes them available on the

Agency for Healthcare Research and Quality (AHRQ)

Web site. Put Prevention Into Practice (PPIP) tools are

revised regularly to correspond with USPSTF updates and

are also available on the AHRQ Web site.

For the most current recommendations and updates, visit

the preventive services section of the AHRQ Web site at

www.preventiveservices.ahrq.gov. Or, for immediate

notification of new and updated recommendations from

the current USPSTF and new resources from the PPIP

program, join the AHRQ Prevention LISTSERV®. To join

the LISTSERV® visit the AHRQ Web site at

www.ahrq.gov/clinic/prev/prevlistserv.htm.

70

This guide was developed by the Agency for Healthcare

Research and Quality (AHRQ), part of the U.S. Department of

Health and Human Services, in partnership with AARP, a

nonprofit, nonpartisan membership organization dedicated to

making life better for people 50 and over.

AHRQ is the lead Federal agency charged with supporting

research designed to improve the quality of health care, reduce

its cost, and broaden access to essential services.

The U.S. Preventive Services Task Force (USPSTF), an

independent panel of experts in primary care and prevention

convened by AHRQ, systematically reviews the evidence of

effectiveness of clinical preventive services—screening tests,

immunizations, counseling, and chemoprevention (for example,

aspirin to prevent heart disease)—and makes

recommendations for their use in primary health care.

This guide is based on USPSTF recommendations from 1996

to fall, 2003.

Put Prevention Into Practice (PPIP), a national program

sponsored by AHRQ, develops resources for clinicians, patients,

and office systems to increase the delivery of USPSTFrecommended preventive services in the primary care setting.

To order copies of this guide, call the AHRQ Publications

Clearinghouse at 1-800-358-9295 or e-mail

ahrqpubs@ahrq.gov.

For more information about AHRQ, visit www.ahrq.gov.

For more information about AARP, call 1-800-424-3410 or visit

www.aarp.org.

The appearance of service marks or logos should not

be construed as an endorsement of any company or

organization—or its services—that has been granted

permission to reprint this publication.