Studies of centenarians, most of whom are healthy and independent, have revealed that it is possible not only to live long, but well. Only about 30 percent of the differences in longevity among people can be traced to heredity. The rest can be attributed to how people live, especially their dietary, exercise and smoking habits and their use of protective medical services like vaccines and early detection tests.
Yet recent surveys have shown that many older Americans are not taking advantage of established methods of protecting their health and lives, including those paid by Medicare. Unless healthy behaviors become the norm for more Americans, too many baby boomers will suffer needless sickness and die prematurely.
"Disease and disability need not be inevitable consequences of aging," said Dr. Jeffrey P. Koplan, director of the federal Centers for Disease Control and Prevention in Atlanta.
"Simple changes in lifestyle: more physical activity, a balanced diet rich in fruits and vegetables and whole grains, and using preventive services like mammograms, colorectal cancer screening and vaccinations can contribute to more years of health and a better quality of life."
The centers in Atlanta last month released data from several surveys showing that older people fall far short of the goals to promote lasting good health. For example, fewer than two older people in five eat five or more servings of fruits and vegetables daily. These foods are strongly linked to protection against heart disease, stroke, some common cancers and loss of vision.
Even for people with small appetites or limited budgets, the five servings are within reach. A serving equals a cup of raw leafy vegetables, a half cup of cooked or raw chopped vegetables, three-fourths cup of vegetable or fruit juice, one medium apple, banana or orange or a half cup of chopped, cooked or canned fruit.
These foods are loaded with protective nutrients and, along with whole grains like oats, whole wheat, bulgur and brown rice, they are the only sources of dietary fiber, which is essential for normal bowel function.
Nor are the elderly getting enough exercise. The centers reported that a third of those 55 to 74 and nearly half of those over 74 are physically inactive. According to experts who prepared an article for a recent issue of Patient Care magazine, "Regular exercise is the single most important health behavior to prescribe for longevity. Exercise can reduce or prevent declines in cardiovascular function, psychological health, muscle mass, postural stability and flexibility. Exercise also improves sleep and decreases the propensity to fall. It is important for all older people, including those in their 80s and 90s, to keep mobile according to their ability."
The experts recommended swimming and described walking as "probably the best and easiest exercise for aging adults." A recent study showed that walking improved the mental abilities of people over 60, including those who had previously been sedentary.
Other preventive measures are likewise underemployed. You'd think that when something is free nearly everyone would get it. But not when it is a vaccine or test for cancer.
Medicare pays for all these: annual flu vaccine; pneumococcal vaccine; annual mammogram; Pap smear and pelvic exam every three years (or annually for high-risk women), and screening tests for colon, rectal and prostate cancers. A 20 percent copayment is required for the cancer tests.
But most older Americans, it seems, are likely to forget about these medical services, and most doctors fail to remind them.
Jane E. Brody writes for The New York Times.