YOUNG AT HEART IN LIMESTONE: Prevention is key to healthy aging

Feb. 25--There's an old adage that says an ounce of prevention is worth a pound of cure, advice that Limestone County residents who find themselves in the 55-and-older age bracket may do well to follow.

Given that many of the leading causes of disease in seniors is preventable, or at least treatable, an annual visit to a family physician or internist is essential. Most private insurance providers, Medicaid and Medicare cover the cost of an annual physical.

According to www.Medicare.gov, a patient with Medicare Part B can expect the following at their yearly examination: a review of medical history, height, weight, blood pressure and other routine measurements, detection of any cognitive impairment, personalized health advice, a list of personalized risk factors and treatment options, a screening schedule for preventative care and the development of a list of current providers and prescriptions.

A more in-depth "Welcome to Medicare" preventative visit, that is available to Medicare Part B recipients within the first 12 months of coverage, includes a calculation of body mass index, a vision test, a review of potential risk for depression and functional abilities and the option to discuss advanced directives.

Dr. Maria Acelajado, an internal medicine specialist at Valley Internal Medicine, conducts a lot of these types of examinations, noting that more than half of her patients are 55 and older.

In addition to a yearly physical, she recommends that everyone over the age of 50 get a colon cancer screening or colonoscopy. In light of the fact that this has been one of the worst flu seasons on record, she strongly suggests that all of her patients receive the flu vaccine and that patients over 65 get a high dose version of the flu shot. All patients should get a pneumonia vaccine every five years, adding that patients 65 or older need two pneumonia vaccines, which last a lifetime. Women over 55 should schedule a mammogram every two years and a pap smear every 3-5 years, but Acelajado added that those recommendations vary based on the current condition of the patient and family history.

According to the Centers for Disease Control and Prevention, the leading cause of death in people over the age of 65 is heart disease. That is why Acelajado tests her patients' lipid levels every five years, more if they have heart disease. A lipid scan measures the levels of "good"and "bad" cholesterol and triglycerides in the blood.

"If a patient has a history of family diabetes, is overweight or obese or sedentary, they need to be screened for diabetes once per year," she said.

A little more than 40 percent of women and 36 percent of men over the age of 65 are considered obese according to the CDC.

A shingles vaccination is also important. Acelajado suggests people take care of that particular vaccine while they still have private health insurance coverage because the shot is not covered under Medicare.

The internist believes there's more to prevention than yearly tests and vaccines, emphasizing that physical activity is also key to healthy aging.

"One of the things we see is that older people are prone to falling, but if they keep their muscles strong with exercise they won't be as weak and as likely to fall," she said.

Acelajado encourages patients who are post-menopausal to take a vitamin D and Calcium supplement to keep bones strong.

Being part of a small community allows doctors like Acelajado to provide seniors with a continuum of care that is personalized and well-coordinated.

"The doctors communicate pretty well in this community because most of us know each other well," she said. "The challenge is that some people see multiple providers and their care becomes fragmented, but here we can coordinate their care better."

She points to an Athens-Limestone Hospital initiative that provides chronic care management to patients. Often, those who suffer from chronic conditions are older and need continued care after being discharged from the hospital. The program coordinates care between Medicare recipients and home health professionals, providing in-home services and access to a 24-hour nurse hotline.

Valley Internal Medicine is currently accepting patients and accepts most private health insurances, Medicaid and Medicare.

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