Aging

Lost sleep, low energy, lagging libido. Those are among the health problems that we often consider a given as we get older. But new research shows they don’t always have to be part and parcel of aging.

“People often blame things on aging that are really due to, say, an underlying medical issue that can be treated, or to a side effect from a drug that they are taking,” says Sharon Brangman, M.D., division chief of geriatrics at Upstate Medical University in Syracuse, N.Y., and a former president of the American Geriatrics Society.

Even your attitude can have an impact. Studies suggest that older adults who think certain health problems are unavoidable have more of them, including poorer memory and a longer recovery from illness. Perhaps that’s because they’re less interested in engaging in healthy behavior that can protect them from disease.

Why do these myths about aging persist? Many physicians have outdated assumptions about older patients, Brangman says. “Most doctors graduated from medical school when geriatrics wasn’t stressed, so they may not know how to respond best to a situation and instead just choose to give a patient another pill,” she says.

We debunk five common myths about aging and give advice on steps you can take to avoid or overcome them.

Sleep patterns do change as we age. “It takes longer to fall asleep, and you tend to have more frequent awakenings than younger individuals,” says Raj Dasgupta, M.D., a sleep specialist at the University of Southern California in Los Angeles. You also get less delta—or slow-wave—sleep. That deeper stage helps you consolidate memory. And without enough sleep you feel more tired, irritable, and forgetful during the day.

But many sleep problems common among older people stem from other causes, notably medication used to treat unrelated health conditions. For example, diuretics taken to lower high blood pressure or treat heart failure can cause you to wake up frequently during the night to go to the bathroom.

What you should do: First, ask yourself whether you’re bothered by your changing sleep pattern. “If it’s not affecting your quality of life, it’s not a problem that needs to be fixed,” Dasgupta says.

If you’re unhappy with it, ask your doctor whether any drug you take or underlying health problem could be affecting your sleep.

If those possibilities are ruled out, consider cognitive behavioral therapy. It’s better than medication for sleep problems, research has found. A psychologist can help you practice good sleep habits, such as getting up and going to sleep at the same time each day. That type of short-term counseling often requires several one-hour sessions. “It can be tough to stick to initially,” Dasgupta says, “but if you do, you can really see benefits.”

Watch out for: Sleeping pills. Almost one-third of older adults are prescribed those drugs, but they help people stay asleep only a few additional minutes per night, research by Consumer Reports Best Buy Drugs suggests.

And the drugs can pose such risks as next-day grogginess, confusion, and memory problems, especially in older adults, who are more sensitive to side effects from them than younger people.

About one-third of people older than 65 fall every year, according to the Centers for Disease Control and Prevention. That’s due in part to a natural decrease in blood flow to the cerebellum—the brain’s balancing center—as well as inner ear and vision changes that make it more difficult to orient yourself, says Mary Tinetti, M.D., chief of geriatrics at the Yale School of Medicine in New Haven. That decline is often exacerbated by conditions like arthritis and nutritional deficiencies that can lead to nerve damage in the feet.

What you should do: Check your balance and strength. “I stress to all my patients that even at age 75 they should be able to get up from a chair without using the arms, walk across the room, turn quickly, and sit down without any unsteadiness,” Tinetti says.

If you can’t, see your doctor, who can check for underlying conditions that can affect balance (a vitamin B12 deficiency, a slow heart rate, or cataracts, for example). He can also refer you to a physical therapist, who can teach you exercises that strengthen muscle and improve balance.

Watch out for: Blood pressure meds. They sometimes lower your blood pressure too much, causing dizziness when you stand and increasing the risk of falls­, especially when starting those drugs or upping a dose. A May 2016 study of 90,127 older adults found a 36 percent increase in serious falls during the first 15 days after starting blood pressure medication.

If you think your medication might be having that effect on you, ask your doctor to check your orthostatic blood pressure, which means comparing your pressure when you’re lying down with your pressure when you stand up. If that test detects a problem, talk with her about lowering your dose or possibly eliminating the drug entirely.

For women, levels of both estrogen and testosterone have declined by menopause, which can lower the sex drive and make sex physically uncomfortable. Many older men still have a strong sex drive, but they may have erection problems because of low blood flow to the penis as a result of clogged arteries stemming from such conditions as high cholesterol and blood pressure levels.

Despite those changes, “as people are living longer, healthier lives, they have all the same expectations that they have in their younger years, which includes sexuality,” says Marc Agronin, M.D., medical director of mental health and clinical research at Miami Jewish Health Systems.

What you should do: If you’re unhappy with your sex life (and not everyone with diminished sexual interest is), talk with your physician. He should check for conditions such as diabetes that can affect arousal. You should also be screened for mood disorders, because up to 90 percent of people with untreated depression experience low libido.

Watch out for: A jump to medication. “Even among older people, psychological issues such as a poor relationship are often the basis for sexual problems, and no medication can fix that,” Agronin says.

More men and even some women are being prescribed testosterone, but taking supplemental doses of it is no magical cure. It has been linked to an increased risk of heart disease in men, for example, and possibly to breast cancer in women.

Prescription drugs to treat erectile dysfunction, including sildenafil (Viagra) and tadalafil (Cialis), can help some men. But they can also cause such side effects as dizziness, headaches, and blurred vision, so be cautious with them. The Food and Drug Administration approved a drug called flibanserin (Addyi) in 2015 for boosting libido in women, but research suggests it isn’t very effective.

“As part of so-called ‘normal’ aging, your mind does slow a bit,” says Ronald Petersen, M.D., a neurologist at the Mayo Clinic in Rochester, Minn. Brain neurochemicals change over time, he says, which explains the little glitches, such as forgetting where you put your keys or the name of a friend at a party.

But only up to 20 percent of people experience more serious problems with thinking or memory, studies suggest. And even that can sometimes be slowed. “Brain aging is not passive—there’s a lot you can do to slow down the process,” says Gary Small, M.D., director of the UCLA Longevity Center. (Read more about how to preserve your memory as you age.)

What you should do: Make sure your doctor screens for high blood pressure, high cholesterol, diabetes, obesity, sleep apnea, and depression—untreated, they can cause cognitive changes—and for hearing and vision loss. If you’re straining to hear or see, your brain can’t focus on encoding memories, Small says.

Watch out for: Antihistamines such as diphenhydramine (Benadryl Allergy, Nytol, Sominex, and generic), anti-anxiety drugs such as diazepam (Valium and generic), and antidepressants such as amitriptyline. They have been linked to cognitive impairment and dementia.

Older people are no more likely than younger ones to be depressed, says Robert Roca, M.D., chairman of the American Psychiatric Association’s Council on Geriatric Psychiatry.

And when they do become depressed, “usually it stems from a loss associated with growing older,” Roca explains. “They lose loved ones or friends, they lose their identity because they retire, their physical vigor declines and they can’t do as many activities as they used to.”

What you should do: Ask your doctor to screen for depression. She can do that with a simple quiz that covers such topics as appetite loss and sleep difficulties.

If you’re mildly depressed, increasing your physical and social activities can help, Roca says. The next step might be therapy—either cognitive behavioral therapy or interpersonal psychotherapy—or, if your depression doesn’t ease, medication.

Watch out for: Anti-anxiety medications. Some doctors prescribe them to treat depression, but this class of drugs, known as benzodiazepines, isn’t appropriate for that purpose. Those drugs also carry the same risks as sleeping pills for older adults, and they can be addictive.