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by Mia James​

There is plenty of good news these days about getting older. Take, for example, that while aging is inevitable, the decline in health, activity, and general well-being associated with advancing years is not. By making health-sustaining choices now, you can look forward to many more years of feeling your best. Staying healthy will also keep medical expenses in check and allow you to maintain your independence. It’s also good news that the steps to sustain good health throughout life are largely within your control, as lifelong wellness relies less on complex medical interventions than on smart lifestyle and preventive practices.

The science of healthy aging can be complex, but the bottom line is straightforward, according to Jeff Harris, MD, MPH, director of the University of Washington Health Promotion Research Center. He encourages people to focus on these essentials: “exercise, maintain a normal weight, don’t smoke, get your shots [immunizations], get your screening tests.” But, he says, people still have a tendency to look for what he calls the “magic bullets” of long-term health—like supplements or nutrients that promise improved health—instead of doing the “basics,” such as exercising and not smoking. These lifestyle measures, says Dr. Harris, are likely the real magic bullets. “The stuff that’s really killing us,” he says, “is not doing the lifestyle part.”

Diane L. Elliot, MD, FACP, FACSM, professor of medicine, Division of Health Promotion and Sports Medicine at Oregon Health & Science University, also emphasizes the importance of healthy lifestyle choices—and exercise in particular—as a means of maintaining health. Staying in motion throughout life is critical, she says, because “there isn’t a health risk that it doesn’t reduce.” Physical activity, she explains, isn’t a luxury; it’s as essential to good health as getting enough sleep or eating well. Furthermore, Dr. Elliot adds that the activity doesn’t have to be rigorous to produce benefits; getting in motion—such as walking or gentle yoga—is what matters.

So it turns out that the real “magic” behind aging well is as simple as sound health practices that focus on physical activity and good nutrition, supported by preventive measures such as disease screening. And, of course, to get the most out of your healthy lifestyle, avoid harmful habits like smoking and alcohol abuse.

Aging Well by Decade

The following guidelines highlight critical steps that you can take throughout your life, beginning in your twenties, to maintain good health as you age. These recommendations are meant to keep your body and mind strong and reduce your risk of cancer and chronic disease. Because the recommendations are general and intended for average-risk women, it’s important that you assess your risk for health concerns (like cancer, diabetes, and heart disease) with your physician and develop personal guidelines.


  • Get screened for cervical cancer. In its recently updated guidelines, the American College of Obstetricians and Gynecologists recommends that women begin cervical cancer screening with a pap test at age 21 and are screened every two years until the age of 30, when screening can be reduced to every three years in women who have had three consecutive normal pap tests. Unless you have a high risk of cervical cancer (which your doctor will help you determine), you may be able to stop screening between the ages of 65 and 70.
  • Have your blood pressure checked. Starting now and continuing throughout your life, have your blood pressure checked at least every two years. High blood pressure is considered 140/90 or higher and can be associated with coronary heart disease, heart failure, stroke, kidney failure, and other health problems.
  • Know your family medical history. Learn and record the health histories of your immediate family (parents and siblings) as well as grandparents and other relatives for whom information is available. Include cancer, heart disease, and other chronic diseases. Your doctor can help you determine what information is important. Family records will help you calculate your own disease risk and guide your lifelong wellness plan.
  • Eat well and exercise regularly. Starting healthy habits now and keeping them up throughout life is an important step toward current and future wellness.
  • Use sunscreen regularly. Protecting your skin from sun damage in your twenties is “when it really makes a difference in terms of preventing skin cancer and wrinkles when you’re in your fifties,” says Dr. Elliot. She recommends choosing sunscreens with a sun protection factor (SPF) of 30 or greater. Also cover up with clothing and a wide-brimmed hat.
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  • Get enough sleep. Family and career demands can make your thirties a busy decade, but making time for adequate sleep is critical to your health. “If you don’t get enough sleep, it increases your risk for cancer and heart disease and affects your mood,” explains Dr. Elliot.
  • Maintain a healthy lifestyle. Keep up with good nutrition, including at least five servings of fruits and vegetables per day, and stay active. Dr. Elliot encourages women to stay active by “making [exercise] part of their lifestyle” rather than an option.


  • Have mammography screening for breast cancer. In recent years annual mammography has been widely recommended beginning at age 40. But in November 2009, the U.S. Preventive Services Task Force changed its guidelines to recommend that mammography begin at age 50 for average-risk women. Other organizations, including the American Cancer Society, have maintained their recommendation that women begin mammography at 40. Ultimately, however, the decision about when you begin mammography is personal and will be best made by consulting your doctor to determine your risk of breast cancer and other factors that will influence your decision.
  • Get a general checkup. “The forties is when a woman really needs a checkup,” says Dr. Elliot. This should include cholesterol, blood sugar, and blood pressure.
  • Learn about menopause. The average age when menstruation ends is in a woman’s early fifties, but you may begin to experience symptoms of menopause (such as hot flashes, fatigue, and mood swings) in your forties. Consult your doctor about what to expect as your body makes this transition and ways to manage changes.


  • Get screened for colorectal cancer. If you have a family history of colorectal cancer, you may want to begin screening before age 50. Otherwise, recommended screening begins at age 50 with the test that you and your doctor determine is appropriate.
  • Be aware of a woman’s risk of heart disease. “The fifties is when heart disease becomes the leading cause of death for women [as well as men],” explains Dr. Elliot, so protect your cardiac health by knowing your cholesterol and staying active.
  • Have a primary care doctor you know and trust. A doctor you’re comfortable with can help you make important healthcare decisions, which are likely to increase with age.
  • Get an annual flu shot. “It turns out that one of the most important things we can do—for men and women—to prevent heart attacks is to get a flu shot,” says Dr. Harris. He explains that flu can contribute to heart attacks because people with flu often don’t get drink enough fluids, and this leads to thickening and clotting of the blood and thus heart attacks. Therefore annual flu shots become increasingly important with age. The CDC and the Advisory Committee on Immunization Practices recommend that flu shots begin at age 50 for average-risk adults.


  • Get screened for osteoporosis. Osteoporosis (thinning of the bones) affects women more than men. So, beginning at age 65 it’s recommended that you be screened for osteoporosis.
  • Prevent osteoporosis. Though osteoporosis is a common age-associated ailment, you can reduce your risk through a diet that is rich in calcium and vitamin D and through regular weight-bearing and resistance exercise. According to the American College of Sports Medicine (ACSM), exercises that put pressure on the bones (such as walking or weight lifting) build bone density, which helps fight osteoporosis. The ACSM recommends that adults perform these strength-training exercises at least twice per week. Dr. Harris adds that strength training can also prevent falls and help women maintain independence and quality of life, as staying strong helps us keep up with daily activities. “Frailty,” he says, “is largely avoidable,” and strength and strong bones are the keys to preventing it.
  • Get appropriate immunizations. In addition to your annual flu shot, other vaccines—such as pertussis (whooping cough) and shingles vaccine after age 60 and pneumonia vaccine after age 65—may also be appropriate. Consult the Advisory Committee on Immunization Practices (see sidebar) for expanded immunization guidelines.
  • Maintain your physical activity and good nutrition to enjoy this decade. “Sixties is the new forties,” says Dr. Elliot. “It’s really a good time for women.”


  • Continue to stay active and eat well. These healthy lifestyle choices are increasingly important with age.
  • Be aware of the increased risk of falling. Regular exercise will help reduce this risk, as will avoiding slippery surfaces and keeping your home free of obstacles like loose cords and rugs.
  • Have your hearing and vision checked.

Eighties and Nineties

  • Keep up the good work! Healthy choices and smart prevention measures have helped you achieve a long, healthy life. Keep up your good habits by staying active and maintaining sound nutrition. Enjoy your good health in the company of family and loved ones.
  • Seek help when needed. If some functions of daily life, such as cooking, transportation, and household chores, are becoming more difficult, ask family and friends for assistance. Your local senior service center can also provide support.

Say No to Smoking

Because cigarette smoking is an established cause of lung cancer and several other cancers as well as of cardiovascular and respiratory diseases, staying away from tobacco (and quitting if you are a smoker) is one of the best things you can do to improve your long-term health.