Healthy Aging Over 65
The vaccines recommended over 65, why strength and balance matter most, and what to review with your doctor.
Last revised
The priorities shift with age: maintaining strength and balance to stay independent, keeping up with vaccines, and reviewing medicines that accumulate over decades.
Strength and balance become the priority
Muscle mass and, more importantly, muscle power decline with age, and power is what gets you out of a chair and catches you when you stumble. The Physical Activity Guidelines for Americans advise older adults to get 150 minutes of moderate activity a week, muscle-strengthening activities on at least two days, and activities that include balance training. Falls prevention is not a side issue: falls are the leading cause of injury in older adults, and a hip fracture is a life-changing event.
Vaccines recommended
A flu vaccine every year, with higher-dose or adjuvanted versions preferred at 65 and older. Pneumococcal vaccination. The two-dose shingles vaccine, recommended from age 50. RSV vaccination, recommended for adults 75 and older and for some younger adults at increased risk. COVID-19 vaccines as currently recommended. Eligibility rules change, so ask your doctor or pharmacist what is due; Medicare covers most of these vaccines.
Medicines add up
Taking several long-term medicines is common by this age, and the risk of interactions and side effects rises with each one. Ask your doctor or pharmacist for a medication review, bringing every prescription, over-the-counter medicine and supplement you take, to check whether each one is still needed at its current dose. Medicines with anticholinergic effects, sleep aids and some blood pressure medicines contribute to falls and confusion and deserve specific attention. The Medicare Annual Wellness Visit is a good time to do this.
The things that get dismissed as age
Hearing loss, which is treatable and is linked to social isolation and cognitive decline. Incontinence, which is common, treatable and frequently never mentioned. Low mood, often put down to circumstances. Dizziness on standing, often a medication effect. Memory changes, which may be nothing or may warrant assessment. None of these is simply age.
At a glance
| Term | Detail |
|---|---|
| Activity guideline | 150 minutes of moderate activity a week |
| Also for older adults | muscle strengthening on 2 or more days, plus balance training |
| Flu vaccine | every year; higher-dose or adjuvanted preferred at 65+ |
| Shingles vaccine | 2 doses, recommended from age 50 |
| Pneumococcal and RSV vaccines | recommended for older adults; ask about current eligibility |
| Worth requesting | a full medication review with your doctor or pharmacist |
| Yearly visit covered by Medicare | the Annual Wellness Visit |
| Commonly dismissed as age | hearing loss, incontinence, low mood, dizziness on standing |
When to get help
Tell your doctor about any fall, even without injury, as falls predict further falls and the cause is often treatable. Get prompt medical care for new confusion, which in older adults frequently signals infection, dehydration or a medication effect rather than dementia. Call 911 for sudden weakness or numbness on one side, difficulty speaking, facial drooping, chest pain, or a fall with a head injury, particularly in anyone taking blood thinners.
Where this comes from
- Office of Disease Prevention and Health Promotion - Physical Activity Guidelines for Americans, 2nd edition
- CDC - Adult Immunization Schedule by Age
- National Institute on Aging - Falls and Fractures in Older Adults: Causes and Prevention
Medical disclaimer
This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.