1 Should I take aspirin or an anti-clotting drug? Although it won't help your symptoms, aspirin could cut some of your extra risk of heart disease and even stroke. That's why most GPs will recommend that you take a low-dose (75mg) aspirin tablet each day. But aspirin raises your odds of developing a stomach ulcer or gastrointestinal bleeding. So if you've had problems with these in the past, or if you already take other pain-relievers every day (such as ibuprofen or a prescription nonsteroidal anti-inflammatory drug, NSAID), or if there's some other reason why you can't take aspirin, your doctor may prescribe an alternative medication with similar anti-clotting effects.
2 Can you help me to lower my blood pressure? If your blood pressure remains above healthy levels despite several months of improved eating, exercise and even weight loss, ask your doctor whether it's time to add blood pressure-lowering drugs to reduce your chances of a heart attack or stroke.
3 What can I do about my blood cholesterol? Changing your diet to reduce saturated fat should help you to slash your 'bad' LDL cholesterol levels. And if you stop smoking, take some exercise, lose any excess weight and have one or two alcholic drinks (but no more) each day, you can raise your levels of 'good' HDL, the type of cholesterol that mops up the bad stuff. Your GP will probably take a blood test to check your 'bad' cholesterol levels and if they're raised you will probably be prescribed a statin drug to reduce them. In fact, some studies suggest that statins are beneficial even if your cholesterol levels are normal,so your GP may recommend them anyway. Statins can improve PAD symptoms, increasing both your overall and pain-free walking distance, as well as reducing your stroke and heart attack risks.
4 How's my blood sugar? A scarcy fact: people with diabetes who have PAD-related leg pain even when they'e resting. If you have diabetes, keeping your blood sugar at healthy levels around the clock lower your odds of these big problems. If you don't, getting regular blood sugar checks (as often as your doctor recommends) can help you to catch pre-diabetes early, in time to slow the development of full-blown diabetes by years - perhaps decades. (For more ways to control blood sugar, turn to part 4 of the book.)
Skin problems
Say the words skin and age, and you probably think about wrinkles. Listen up - forget about wrinkles. Normal, age-related wrinkles do you no harm. You are beautiful with them; don't let advertising, plastic surgeons or shallow, vain friends convince you otherwise. Years of sun exposure, not discovering moisturiser until your 30s and a persistent rosy flush on your face - these are skin issues that adults over 40 should be most concerned with.
Consider this: when you're young, your top layer of skin typically turns over every 26-42 days. From around the age of 30, that turnover rate slows. By your 80s, your skin takes 50 percent longer to renew itself. And that's the problem. Now the protective outer layer of your skin is just hanging around for longer, and its function is impaired.
That in turn leads to a host of skin-related problems, including dryness and a greater susceptibility to irritation. It also means that dead skin cells stay on the surface for longer, giving your skin a dull appearance and rough texture. That dryness and flaking can also make your skin itchy, sometimes resulting in red, scaly patches of eczema. Plus, your oil glands produce less oil, which also contributes to dyrness.
Your skin also thins with age, with one study finding that women over 65 had lost about 20 percent of their skin thickness. This is why skin becomes more sensitive to creams and oils with age. Just a little permeates the skin more completely and may lead to the itchiness and rashes of contact dermatitis.
This time of life is also when the sunbathing of your youth returns to haunt you. Any time the sun hits your skin, it creates an inflammatory reaction that breaks down collagen - the binding material in your skin - as well as elastin fibres. That's why people who spent a lot of time in the sun when they were younger may have that leathery look.
Ageing also delivers two other challenges to the skin.
Shingles is a painful skin condition in which the nerves just under the skin become inflamed. It's caused by the chickenpox virus, which had lain dormant in your system all these years just waiting for your immune system to weaken. About 20 percent of people aged 60 and older who get shingles are left with a painful condition called post-herpetic neuralgia.
Rosacea starts out looking like blushing or ordinary skin redness, but, eventually, tiny pimples and very noticeable blood vessels may appear, particularly on your nose and cheeks. Rosacea affects about one in ten people in the UK, more women than men, and typically strikes between the ages of 30 and 50. Scientists don't really understand what causes it, but 'leaky' blood vessels sun damage, a reaction to a skin micro-organism, or abnormal immune or inflammatory responses may be involved.
While these last two conditions require medical treatment, usually in the form of laser therapy and/or prescription medication, there are certain lifestyle steps you can take either alone or as an add-on to your doctor's care, to protect your skin.
To manage dry, itchy skin
Skip the soap If your skin is showing signs of ageing, then your days of using soap are probably over - most soaps are simply too drying for older skin. The British Association of Dermatologists (BAD) recommends that older people avoid soap, bubble bath and shower gels, which strip the skin of its natural oils. Instead, use moisturising soap subsitutes, and apply the lotion directly to the skin with a flannel or sponge. Rinse with warm water - not hot or cold - and apply a moisturising cream afterwards.
Slap on the moisturiser Forget fancy ingredients and 100-an-ounce anti-ageing treatments. Any basic moisturiser will do a good job. Use on still-damp skin, to lock in water, and moisture at least twice a day - when you first step out of the shower, before your skin is completely dry (the moisturiser will form a film over your skin, locking in liquid), and again before you go to bed after cleansing your face with a moisturising cleanser. Use moisturiser on your whole body - you need about 30g all over the skin for each application, says the BAD - so be sure to buy a big tub.
Hydrate the air It's common sense that dry air is bad for dry skin, and if you have a modern, centrally heated home with double glazing, the air indoors may become quite dry in the winter. If so, moisturise the air and your skin with a humidifier. You can have a humidifier installed as part of your heating system or use portable version. Another way to put more moisture into the air in winter is to hang just-washed clothes to dry in the house. A final spin in the dryer helps to remove any stiffness and wrinkles.
Exfoliate at least weekly Exfoliation is the process of removing dead cells from the skin's surface to reveeal 'younger', fresher-looking skin below. It helps to get rid of the dull look that ageing can bring, as well as shrinking the appearance of large pores and removing any flakiness from dry skin. Typically, you use a cream exfoliant to do the job. But if these are too harsh for your skin, try a cleanser with 10 percent alpha-hdroxy acids (AHA), naturally occurring acids that act as exfoliators. If you use products with AHAs, look for over-the-counter brands with glycolic acid, which seems to penetrate the skin best.
Wear gloves Not for warmth, but for skin protection. Use rubber gloves for washing dishes, doing housework and handling household cleaners. Even better, switch to gentler, 'green' cleaners that aren't made with harsh chemicals, or use natural ingredients such as vinegar for cleaning. But still wear the gloves.
Take your vitamins Antioxidant vitamins (A, C and E) help to combat skin damage from free radicals, whether they come from your diet, sunlight or pollutants in the air. Ensuring a good intake of antioxidants from foods can help skin-repair processes, boost collagen production and help to retain moisture. But take your vitamin E in a skin cream, not as a supplement - there's some evidence that vitamin E supplements taken by mouth can be hazardous for older people.
Take a warm bath Add ten drops of chamomile oil to bathwater, then soak for 10 minutes. Other bath additions to help itchy skin include oatmeal and geranium, hyssop, peepermint and myrrh essential oils (use ten drops of one type). Don't forget to slap on the moisturiser afterwards, and make sure the water is warm, not hot. Hot water tends to dry out the skin.
Swallow some evening primrose Several studies find that taking this omega-3 fatty acid significantly reduces itching and rashes related to dry skin, most likely by increasing levels of anti-inflammatory chemicals in the blood. Take four 500mg capsules twice a day until your condition improves.
2 Can you help me to lower my blood pressure? If your blood pressure remains above healthy levels despite several months of improved eating, exercise and even weight loss, ask your doctor whether it's time to add blood pressure-lowering drugs to reduce your chances of a heart attack or stroke.
3 What can I do about my blood cholesterol? Changing your diet to reduce saturated fat should help you to slash your 'bad' LDL cholesterol levels. And if you stop smoking, take some exercise, lose any excess weight and have one or two alcholic drinks (but no more) each day, you can raise your levels of 'good' HDL, the type of cholesterol that mops up the bad stuff. Your GP will probably take a blood test to check your 'bad' cholesterol levels and if they're raised you will probably be prescribed a statin drug to reduce them. In fact, some studies suggest that statins are beneficial even if your cholesterol levels are normal,so your GP may recommend them anyway. Statins can improve PAD symptoms, increasing both your overall and pain-free walking distance, as well as reducing your stroke and heart attack risks.
4 How's my blood sugar? A scarcy fact: people with diabetes who have PAD-related leg pain even when they'e resting. If you have diabetes, keeping your blood sugar at healthy levels around the clock lower your odds of these big problems. If you don't, getting regular blood sugar checks (as often as your doctor recommends) can help you to catch pre-diabetes early, in time to slow the development of full-blown diabetes by years - perhaps decades. (For more ways to control blood sugar, turn to part 4 of the book.)
Skin problems
Say the words skin and age, and you probably think about wrinkles. Listen up - forget about wrinkles. Normal, age-related wrinkles do you no harm. You are beautiful with them; don't let advertising, plastic surgeons or shallow, vain friends convince you otherwise. Years of sun exposure, not discovering moisturiser until your 30s and a persistent rosy flush on your face - these are skin issues that adults over 40 should be most concerned with.
Consider this: when you're young, your top layer of skin typically turns over every 26-42 days. From around the age of 30, that turnover rate slows. By your 80s, your skin takes 50 percent longer to renew itself. And that's the problem. Now the protective outer layer of your skin is just hanging around for longer, and its function is impaired.
That in turn leads to a host of skin-related problems, including dryness and a greater susceptibility to irritation. It also means that dead skin cells stay on the surface for longer, giving your skin a dull appearance and rough texture. That dryness and flaking can also make your skin itchy, sometimes resulting in red, scaly patches of eczema. Plus, your oil glands produce less oil, which also contributes to dyrness.
Your skin also thins with age, with one study finding that women over 65 had lost about 20 percent of their skin thickness. This is why skin becomes more sensitive to creams and oils with age. Just a little permeates the skin more completely and may lead to the itchiness and rashes of contact dermatitis.
This time of life is also when the sunbathing of your youth returns to haunt you. Any time the sun hits your skin, it creates an inflammatory reaction that breaks down collagen - the binding material in your skin - as well as elastin fibres. That's why people who spent a lot of time in the sun when they were younger may have that leathery look.
Ageing also delivers two other challenges to the skin.
Shingles is a painful skin condition in which the nerves just under the skin become inflamed. It's caused by the chickenpox virus, which had lain dormant in your system all these years just waiting for your immune system to weaken. About 20 percent of people aged 60 and older who get shingles are left with a painful condition called post-herpetic neuralgia.
Rosacea starts out looking like blushing or ordinary skin redness, but, eventually, tiny pimples and very noticeable blood vessels may appear, particularly on your nose and cheeks. Rosacea affects about one in ten people in the UK, more women than men, and typically strikes between the ages of 30 and 50. Scientists don't really understand what causes it, but 'leaky' blood vessels sun damage, a reaction to a skin micro-organism, or abnormal immune or inflammatory responses may be involved.
While these last two conditions require medical treatment, usually in the form of laser therapy and/or prescription medication, there are certain lifestyle steps you can take either alone or as an add-on to your doctor's care, to protect your skin.
To manage dry, itchy skin
Skip the soap If your skin is showing signs of ageing, then your days of using soap are probably over - most soaps are simply too drying for older skin. The British Association of Dermatologists (BAD) recommends that older people avoid soap, bubble bath and shower gels, which strip the skin of its natural oils. Instead, use moisturising soap subsitutes, and apply the lotion directly to the skin with a flannel or sponge. Rinse with warm water - not hot or cold - and apply a moisturising cream afterwards.
Slap on the moisturiser Forget fancy ingredients and 100-an-ounce anti-ageing treatments. Any basic moisturiser will do a good job. Use on still-damp skin, to lock in water, and moisture at least twice a day - when you first step out of the shower, before your skin is completely dry (the moisturiser will form a film over your skin, locking in liquid), and again before you go to bed after cleansing your face with a moisturising cleanser. Use moisturiser on your whole body - you need about 30g all over the skin for each application, says the BAD - so be sure to buy a big tub.
Hydrate the air It's common sense that dry air is bad for dry skin, and if you have a modern, centrally heated home with double glazing, the air indoors may become quite dry in the winter. If so, moisturise the air and your skin with a humidifier. You can have a humidifier installed as part of your heating system or use portable version. Another way to put more moisture into the air in winter is to hang just-washed clothes to dry in the house. A final spin in the dryer helps to remove any stiffness and wrinkles.
Exfoliate at least weekly Exfoliation is the process of removing dead cells from the skin's surface to reveeal 'younger', fresher-looking skin below. It helps to get rid of the dull look that ageing can bring, as well as shrinking the appearance of large pores and removing any flakiness from dry skin. Typically, you use a cream exfoliant to do the job. But if these are too harsh for your skin, try a cleanser with 10 percent alpha-hdroxy acids (AHA), naturally occurring acids that act as exfoliators. If you use products with AHAs, look for over-the-counter brands with glycolic acid, which seems to penetrate the skin best.
Wear gloves Not for warmth, but for skin protection. Use rubber gloves for washing dishes, doing housework and handling household cleaners. Even better, switch to gentler, 'green' cleaners that aren't made with harsh chemicals, or use natural ingredients such as vinegar for cleaning. But still wear the gloves.
Take your vitamins Antioxidant vitamins (A, C and E) help to combat skin damage from free radicals, whether they come from your diet, sunlight or pollutants in the air. Ensuring a good intake of antioxidants from foods can help skin-repair processes, boost collagen production and help to retain moisture. But take your vitamin E in a skin cream, not as a supplement - there's some evidence that vitamin E supplements taken by mouth can be hazardous for older people.
Take a warm bath Add ten drops of chamomile oil to bathwater, then soak for 10 minutes. Other bath additions to help itchy skin include oatmeal and geranium, hyssop, peepermint and myrrh essential oils (use ten drops of one type). Don't forget to slap on the moisturiser afterwards, and make sure the water is warm, not hot. Hot water tends to dry out the skin.
Swallow some evening primrose Several studies find that taking this omega-3 fatty acid significantly reduces itching and rashes related to dry skin, most likely by increasing levels of anti-inflammatory chemicals in the blood. Take four 500mg capsules twice a day until your condition improves.
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