Men's Health After 60: Checks Worth Doing

Checks worth doing

Ask the doctor how often is right for you, as it depends on age, family history and existing conditions.

• Blood pressure, at least yearly, and at home if high or treated; see how to measure blood pressure at home accurately and hypertension home care guide.
• Blood sugar (fasting and HbA1c), yearly or as advised; see diabetes after 60: a home care guide and how to test blood sugar at home.
• Cholesterol and kidney tests, yearly or as advised; see cholesterol in elders.
• Weight, waist and body mass, as extra abdominal fat raises heart and diabetes risk; see weighing scales and unplanned weight loss in older adults.
• Heart assessment: electrocardiogram and further tests if there are symptoms or risk factors; see heart failure at home: daily checks and warning signs.
• Prostate: discuss symptoms and screening (see below); see prostate problems and urinary symptoms in older men.
• Bowel cancer screening and review of bowel habits, as advised.
• Eyes, hearing and teeth: yearly or two-yearly; see hearing and vision checkup schedule and mouth, teeth and general health in older adults.
• Skin check for new or changing moles and sores that do not heal.
• Bone health: men can also get osteoporosis, especially with long-term steroid-type medicines, heavy smoking or alcohol, low weight or previous fracture; ask about a scan; see osteoporosis at home: preventing fractures and living well.
• Thyroid, vitamin B12, vitamin D and anaemia if tired or at risk; see thyroid problems in older adults, vitamin B12 in older vegetarians and fatigue and anaemia in older adults.
• Sleep apnoea if loud snoring, pauses in breathing or daytime sleepiness; see sleep apnoea in older adults: signs and next steps.
• Memory and mood screening if concerned; see mild cognitive impairment: what it is and what families can do.
• Vaccines: influenza, pneumococcal, tetanus and others as advised; see vaccines for older adults in India: a practical schedule.
• Medicine review once a year; see polypharmacy and deprescribing: taking fewer, better medicines.

Habits that make a difference

• Be active: at least about 150 minutes of moderate exercise a week, plus strength work twice a week; see exercise at home for seniors: a starter guide, strength after 60: how much is enough and dumbbells guide for seniors.
• Eat for health: more vegetables, fruit, whole grains, pulses, nuts and fish; less salt, sugar, fried food and processed meat; adequate protein; see nutrition for heart health after 60 and how much protein do older adults need.
• Stop tobacco: smoking, bidis, gutka, paan and chewing tobacco cause heart, lung and mouth cancers. It is never too late to quit; ask the doctor for help.
• Limit alcohol: alcohol interacts with medicines, raises blood pressure, causes falls and harms the liver and brain; see alcohol and medicines in older adults.
• Sleep well, and treat sleep apnoea; see sleep problems in older adults.
• Keep friends and purpose: loneliness harms health as much as smoking; see loneliness and isolation in older adults and retirement, identity and mood.
• Keep hydrated and manage heat and cold; see hydration for older adults: how much and how to remember.
• Prevent falls; see falls risk assessment at home.

Prostate health

The prostate is a walnut-sized gland below the bladder that tends to enlarge with age, squeezing the urine pipe. Common symptoms: slow stream, hesitancy, dribbling, getting up at night to pass urine, urgency and incomplete emptying. Most cases are due to benign enlargement, not cancer, but symptoms can overlap.

See a doctor for urinary symptoms; sudden inability to pass urine is an emergency (call 112 or go to hospital); blood in urine, fever with urinary symptoms, or severe back or bone pain need prompt review.

PSA blood test for cancer screening is debated. It can detect cancer early but may also lead to unnecessary tests and treatment for slow-growing cancers. Doctors usually advise discussing the benefits and harms, your age, health and family history before deciding. Do not have the test, or avoid it, without understanding what the result might mean.

Details are in prostate problems and urinary symptoms in older men and urinary tract infections in older adults.

Testosterone and "andropause"

• Testosterone falls gradually, by about one per cent a year on average from middle age, but many older men still have levels in the normal range, and symptoms such as tiredness, low mood, reduced desire and weight gain have many other causes: sleep apnoea, depression, obesity, diabetes, thyroid disease, alcohol, medicines, chronic illness.
• A diagnosis of true low testosterone requires symptoms plus repeatedly low blood levels, measured by a doctor, typically in the morning on more than one occasion, with a search for causes.
• Testosterone treatment is not a general anti-ageing remedy. In men with proven deficiency and troublesome symptoms, a specialist may consider it, but it has risks, including thickened blood, effects on the prostate, sleep apnoea and possible heart risks. It requires monitoring.
• Avoid unsupervised testosterone, "booster" tablets, injections and gym products, which may contain unlisted ingredients; see supplements and medicine interactions: a safety guide and spotting fake or poor quality care products.
• If you are worried, ask the doctor to look for treatable causes first.

For intimacy concerns, see intimacy and sexual health in later life.

Mood and mental health

Men often hide low mood, and may express it as irritability, anger, drinking more, withdrawing or aches rather than sadness. Retirement, bereavement, illness, money worries and loneliness are common triggers; see depression in older adults, anxiety in older adults, grief and bereavement in later life and retirement, identity and mood.

Signs to act on: persistent low mood for two weeks, loss of interest, poor sleep or appetite, hopelessness, heavy drinking, giving away belongings, talk of being a burden or of ending life. Take any talk of suicide seriously: stay with the person, stay calm, remove access to means such as medicines, and seek help immediately. In India, Tele-MANAS (14416) is the national mental health helpline (check the current number); call 112 if there is immediate danger.

Heart attack and stroke: know the signs

Call 112 immediately for: - Chest pain, pressure or tightness, spreading to the arm, jaw or back, with sweating, breathlessness, nausea or faintness; do not dismiss it as gas. - Sudden face droop, arm weakness, speech difficulty, confusion, vision loss or severe headache; see stroke warning signs and the first hour. - Fainting or collapse.

Do not drive yourself; wait for the ambulance; see ambulance and emergency numbers in India.

Making it easier to go to the doctor

• Book a yearly "health MOT" and treat it like servicing a vehicle.
• Use a checklist and bring the medicine list; see preparing for a doctor's visit with a parent.
• Ask a family member or friend to go with you.
• Be honest about drinking, smoking, mood, urine, bowels and intimacy; doctors hear these daily.
• Keep records; see keeping a health record at home.
• Consider a geriatric assessment if there are many conditions; see comprehensive geriatric assessment explained.

When to ask a professional

Ask the family doctor for a check-up plan; a urologist about prostate symptoms; a cardiologist about heart symptoms; an endocrinologist about testosterone concerns; a counsellor for mood. Ask a pharmacist before supplements. Seek urgent help for emergencies.