Intro: This is BayCare HealthChat, another podcast from BayCare Health System.

Joey Wahler (Host): During aging, as our bodies change, so too does how we should go about staying in good health. So we're discussing staying healthy after 65. This is BayCare HealthChat, a podcast from BayCare. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Fred Brennan, Jr., a family and sports medicine physician for BayCare. Dr. Brennan, thanks for joining us.

Dr. Fred Brennan: Oh, thank you. Good morning.

Joey Wahler (Host): Good morning to you. So, first, what happens at age 65 that changes our health or how we go about maintaining it?

Dr. Fred Brennan: Well, you know, that's interesting because everybody ages at a different level and different pace. So there are some 65-year-olds, as you know, that really are physiologically and mentally at 45. And then, other folks that are at 65 and unfortunately their health, et cetera, is that maybe of a 75-year-old or older. So I don't think it's necessarily a number, but we do know that at age 65, it does seem like our bodies do take a little longer to recover from things like exercise. And we do have different nutritional needs at that point also.

Joey Wahler (Host): Well, speaking of exercise, Doctor, how important is a daily exercise routine of some sort and what exactly should people around 65 or older, again we're generalizing, but typically around that age, what should people be doing physically?

Dr. Fred Brennan: Well, again, sometimes health will dictate that, right? If you have a lot of arthritis or other medical conditions, that may limit your ability to exercise. But in general, if you are healthy enough to exercise, and I think most people are able to get some activity. There are actually a lot of good exercises and I think probably the best bang for your buck is simply walking. Walking is a great exercise. And if you can get in, the recommendations are about 150 minutes a week. So if you can do 30 minutes a day, five days a week, that's great. If you can get an hour in couple days a week, that's great. It's just a matter of getting in some activity. Swimming, bicycling are also excellent forms exercise for those over 65.

Joey Wahler (Host): And speaking of exercise as well, how about the importance of exercising one's mind? What are the best ways as we get older of doing that?

Dr. Fred Brennan: Yes, that's also really important. I think part of that is avoiding I call the I's, isolation and inactivity. And so in other words, isolating yourself from people or isolating yourself or being inactive both mentally and physically is really something you need to avoid at 65. And so things like reading, I think reading is an excellent form of keeping your mind sharp. Certainly, finding the things that you like to read and not something that other people want you to read. You would want definitely to pick up something you like to read and enjoy. That's really important. People like to do crossword puzzles and other things as well. And there's a lot of online things that people can do to try to keep your mind sharp, but it's very important to exercise your mind in some capacity, and not just watch television when you get to be over 65 and let your mind sort of wander. It's very, very important to do that, exercise your mind with reading and other things.

Joey Wahler (Host): Gotcha. Now, regarding diet, what are some things as we get older that we should eat more of or less of?

Dr. Fred Brennan: Well, I think unfortunately as our metabolism slows down, especially really over 40, but certainly by 65, our metabolism is slowing down and I think not only portion control, but what we eat is very important and also the timing. And I think what we need to be really processing as far as eating is less carbohydrates and more protein. And we definitely know from studies that folks over 65, unfortunately, are not getting enough protein. A lot of them are not getting enough protein in their diet every day. So they become protein malnourished, if you will. So less carbohydrates, more protein, more water. Most of the folks over 65, unfortunately, really don't drink enough water on average. That's not true for everyone. And I think, again, that timing is great. It's not time to pick up a burger or an unhealthy meal after 7:00, 8:00 at night where your body is just not going to be able to process that well as you get older.

Joey Wahler (Host): Well, you mentioned drinking. I want to ask you about that, because two things often overlooked as being important as we age, drinking enough water and getting enough sleep. So what's the right amount of each at an older age?

Dr. Fred Brennan: I think it's individualized, so we can make some general statements. And I think depending on if you're outside and active, of course, and you are losing more water because you're sweating, then of course your water intake is going to go up. And in general, if you are out exercising, for example, 12, 16 to 20 ounces of water an hour, if you are sweating a lot. In general, 4, 5, 6 glasses of eight to ten-ounce glasses of water for most folks will be good if they're not doing a lot of exercise. And I think that's very important and they really need to watch their urine, their color. For example, if it's dark yellow, for example, as opposed to pale, then you know they're probably not getting enough water, that they're getting a little on the dehydrated side and need to increase their water intake. And finally, as far as sleep, it needs to be quality sleep, not just hours. They need to feel rested when they wake up. And usually, six hours or more for folks over 65 is adequate. So I'd recommend at least six hours of good quality sleep a night for those folks over 65.

Joey Wahler (Host): Now, getting older also means it's important to be more diligent about taking medication. So what does that involve?

Dr Fred Brennan: Yes, unfortunately, you know, my parents and I don't know yours, but others, we find that sometimes that folks will tend to either forget to take their medications or their timing of their medication is off. Also the problem, we do this sometimes, is we self-adjust. You know, "Oh, our blood pressure's a little high today. Let me take an extra blood pressure medication, an extra pill today" or "Oh, my blood pressure looks pretty good today. I don't really need to take that medication." And I think we find a lot, especially folks over 65, that usually they take more than one medication as they're self-adjusting or they're skipping doses. And I really tell folks, please don't do that. Really talk to your health care provider about what medications you're on, make sure that they know what you're taking, your provider, as well as any kind of supplements, very important, because sometimes they can interact with your medications. But also, if you think you need a change, call or send a message through our patient portal to your provider and say, "Listen, I think I need to change this. Can we change this medication dose? Or can I take it only once a day instead of twice a day?" And talk it over with your provider in some fashion instead of self-adjusting. I think that can get people in big trouble and we don't want them to have a fall or something else because they've adjusted their medications without talking to their provider.

Joey Wahler (Host): Yeah, definitely. Great advice there. How about, you alluded to this earlier, the importance of older people socializing, being around others, interacting, keeping the mind going, but also just not being alone and enjoying yourself and laughing on a regular basis, right?

Dr. Fred Brennan: Exactly. Yes. I think a lot of folks, they get away from their job, they retire or semi-retire, and they're not interacting with people as much, and they start to withdraw a little bit. And I think unfortunately they start to withdraw mentally and they start to isolate themselves as we talked about and that's not good, because we really are social beings and we really do need to do some socialization. And I understand that some people like to have their privacy, but doesn't mean they can't get out a little bit and interact with folks, whether it's going out bowling or just going out for a walk with a friend.

And it's so important to laugh. I think exercise and laughter are some of the two best medicines that you can prescribe for yourself and avoiding that isolation. I think people that get over 65, if they really lose their friend network or they isolate themselves, then we see that decline not only in their mental health, but unfortunately their physical health.

Joey Wahler (Host): Let's talk for a moment about pets, because we all know they can have such a positive impact on people of all ages, of all conditions. But how can they help us especially as we age?

Dr. Fred Brennan: It does seem, and the studies have certainly shown this where having a pet certainly is good for the elderly, those over 65 and even for younger folks and families. But there's no doubt that pets provide companionship. And for folks over 65 who may have lost a loved one or a spouse, and they really are by themselves, we know that pets do improve their mood and their attitudes. They tend to sleep better. They tend to be healthier in general when they have a pet. So, it is firstly for those who are alone and elderly over 65, having a pet that they can walk, that they can talk to, absolutely has been found to be helpful for the elderly folks over 65 and others too. Pets are great. And I can understand that not everybody loves pets and sometimes their environment where they live doesn't allow pets. But it is definitely a positive thing for us to have a pet if we can.

Joey Wahler (Host): And then, finally, I want to ask you this, doc, I know from personal experience with certain family members, often as people get older, especially into their 70s, 80s, never mind 60s, they start to poo poo possible health issues, don't they? Sometimes even people that were so diligent about staying on top of their health, going to the doctor regularly, et cetera, when they were younger. As they get older though, often say, "Ah, let it go," "Ah, it's nothing," "Ah, I don't want to go to the doctor. I don't feel like it." What's your message for people as they get older about not doing that?

Dr. Fred Brennan: Well, bring up a good point because, yes, as we get older, you know, our priorities sometimes will shift and sometimes people will put their own health needs on the back burner sometimes to take care of others that are elderly or not doing well. Sometimes they'll just say, "Listen, I can't take care of myself right now. I get to take care of my family member," and I understand. But prevention is really important. And because if you can pick things up early in the process, for example, in early breast cancer or early colon cancer, you have to be screened for that. You have to look for that. And if you don't, unfortunately, sometimes these things will get discovered too late.

And so I really tell people don't give up your health care maintenance. Continue to get your immunizations when you need them. Get your colon cancer screening when you need that. Any other screening test that your provider recommends, don't forget to do that because, again, if we pick up something earlier, it may be a fairly easy cure, where if you continue on and let it grow and get worse, ignore your abdominal pain and there's something inside your abdomen growing that shouldn't be, that's sad. Why end your life at an early age, when if you had picked it up earlier, you might have been able to take care of it and cure it? So prevention at all ages is so important. Don't give up on your health. It's so important. Enjoy life as long as you can.

Joey Wahler (Host): Absolutely. Great way to end and folks, we trust you're now more familiar with staying healthy after 65 or whenever it is that your body or health start to change. Dr. Fred Brennan, Jr., thanks again so much.

Dr, Fred Brennan: You're very welcome. Thanks for having me on.

Joey Wahler (Host): Same here. And for more information or to reach a provider, please visit BayCare.org. Again, that's B-A-Y-C-A-R-E.org. Also, please remember to subscribe, rate and review this podcast and all the other BayCare podcasts. For more health tips and updates, follow BayCare on your social channels. If you found this podcast helpful, please do share it on your social media and check out all their other podcasts as well. And thanks for listening to BayCare HealthChat, a podcast from BayCare. Hoping your health is good health, I'm Joey Wahler.