Issues in Geriatric Care: Maintaining Health and Vigor.

Medicare covers annual wellness visits that are scheduled separately from regular medical appointments. These visits focus on prevention and health maintenance to help patients achieve successful aging, which is defined as living to old age without disability while also maintaining high physical and psychological levels of functioning and social engagement. To achieve these goals, most adults should perform at least 150 min/week of moderate-intensity exercise and maintain an optimal body mass index (ie, 23 to 32 kg/m2 ). Healthy diets for most older adults include 1 to 1.2 g/kg/day of protein, with more for individuals with serious acute or chronic conditions. A varied vitamin-rich diet should be consumed. In the absence of deficiencies, vitamin supplements are unnecessary. Neither testosterone nor growth hormone supplementation is recommended. When patients have difficulty sleeping, physicians should assess for conditions affecting sleep and promote good sleep hygiene rather than prescribe hypnotics. Screening for depression and assessing driving safety are important. Smoking cessation and limiting alcohol ingestion to small amounts have benefits even in older age. Cancer screening should be offered only to patients with life expectancy of at least 10 years and who understand the risks and benefits.