5 ‘Silent’ Health Threats to Watch Out For as You Age

2. High cholesterol

High LDL cholesterol — often called the “bad” cholesterol — and other fats may be secretly circulating in your bloodstream, quietly laying the groundwork for a heart attack or stroke.

“We call high blood pressure and high cholesterol silent epidemics for a reason,” says Dr. Joshua Septimus, an internist at the Houston Methodist Primary Care Group in Bellaire, Texas. “They are totally asymptomatic until it’s too late and you have a heart attack or a stroke.”

You may already know that certain lifestyle habits, such as smoking, lack of exercise and eating foods high in saturated fat, can raise your LDL levels. But Septimus says an inherited type of cholesterol — lipoprotein-a or Lp(a) — can affect your numbers too.

It’s a subtype of LDL cholesterol that, when too high, can slow the flow of blood through your arteries in several different ways. You can detect Lp(a) only with a specific blood test, and experts recommend that every adult have this test at least once in their lifetime.

Why you should watch out for high cholesterol

Over time, cholesterol builds up in the walls of your arteries and forms a hard plaque, a condition called atherosclerosis. This makes it difficult, or eventually impossible, for oxygenated blood to travel through these narrowing passageways from the heart to the other organs, depriving those organs of the oxygen they need.

Depending on which arteries the cholesterol blocks, atherosclerosis can lead to several different types of heart disease, including coronary artery disease, peripheral artery disease and carotid artery disease, in addition to high blood pressure and stroke.

Catch it before it catches you

• Make sure your primary care doctor checks your cholesterol every year. An LDL below 100 milligrams per deciliter (mg/dL) is considered the target for most healthy adults. If yours is higher than that, ask your doctor what action you might need to take.
• Ask whether an Lp(a) test makes sense for you — especially if heart disease runs in your family.

3. Type 2 diabetes

About 40 million U.S. adults have diabetes — but 1 in 4 don’t know they have it, according to the U.S. Centers for Disease Control and Prevention. And that’s because it often doesn’t show any symptoms until your blood sugar has gotten way out of control.  

“You might notice some increased thirst or increased urination, but often people don’t realize it until their sugars are very, very high,” says Colon-Emeric.

The road to type 2 diabetes, which is most commonly diagnosed in adults over 45, begins long before you develop high blood sugar, Septimus says. It starts with insulin resistance — when your body stops responding to insulin, which is responsible for breaking down sugar and turning it into energy.

Insulin resistance typically develops as a result of an unhealthy lifestyle, which includes poor diet, too little physical activity and being overweight.

“If you’ve got a belly, you need to make it smaller,” Septimus says. “Reduce processed foods, reduce sugar.”

Why you should watch out for type 2 diabetes

Type 2 diabetes raises your risk for:

• Heart disease, stroke and atherosclerosis
• Nerve damage, especially in the hands and feet
• Nerve damage in organs, which can lead to heart arrhythmias, digestive problems and erectile dysfunction
• Kidney disease
• Eye diseases
• Hearing loss
• Dementia

Catch it before it catches you

Get a hemoglobin A1C test, which shows your average blood sugar over the past three months, at your annual wellness visits. Discuss the results with your doctor and find out if you need to take further action.

Primary care clinicians typically order this test at every routine physical, but “if they don’t, then that would be a good thing to ask for, particularly if you have a family history of diabetes or if your body mass index is over 25,” says Colon-Emeric.

4. Brittle, thinning bones

You naturally lose bone mass as you age, but some people develop a bone disease called osteoporosis, characterized by thin, brittle bones. Many don’t know it, however, until they break a bone.

“Osteoporosis remains asymptomatic until that fracture,” Colon-Emeric says. Often the first sign is a broken hip, wrist or spine after a minor fall.

Fractures in older age can lead to a rapid loss of independence and many other complications. But these fractures are preventable with treatment for osteoporosis.

Why you should watch out for osteoporosis

A hip fracture is a major cause of loss of independence. Up to 60 percent of people who were independent before a hip fracture need help with some activities of daily living for up to two years afterward. Up to 20 percent of older adults move to a care facility after a hip break, and many never regain the ability to walk without assistance.

How to catch it before it catches you

• If you’re over 50 and you break a bone, get a bone density test to determine whether you need medication for osteoporosis.
• Women over 65 should get a test regardless of their history of broken bones. Men should get tested at age 70.
• Make sure you’re hitting daily recommended levels for intake of calcium and vitamin D. Ask your doctor if you should be tested for deficiencies and whether you might need supplements.

5. Age-related eye diseases

Glaucoma and early age-related macular degeneration (AMD) can sneak up quietly and cause irreversible vision loss. With glaucoma, Colon-Emeric says, “you don’t get symptoms until you’ve lost about half of those retinal cells.”

Macular degeneration can also progress for years before you notice changes in your vision.

Why you should watch out for eye diseases

Untreated, age-related eye diseases — including glaucoma, macular degeneration and even diabetic retinopathy — can lead to vision loss that could cost you your independence. Detecting these conditions early can open the door to treatments that may stop or slow their progress.

How to catch it before it catches you

“Routine screening with an ophthalmologist is now recommended every one to two years for folks over age 65,” says Colon-Emeric.

Catch all these conditions before they catch you

While it’s important to stay up to date on routine screenings to catch these sneaky conditions early, it’s even better to avoid them in the first place. And experts say healthy habits help to lower your risk for every condition on the list.

“Lifestyle is under-deployed,” Dodson says. “It’s hard, but lifestyle changes can lower blood pressure, improve diabetes, control cholesterol and prevent many of these other conditions.”

The following habits are linked to a lower risk of each of the five silent conditions, as well as many other health problems:   

• A plant-forward, heart-healthy diet, such as the Mediterranean diet or the MIND diet.
• 150 minutes weekly of moderate to vigorous physical activity that includes cardio, weight-bearing exercise (something that requires you to support your own weight, such as tennis or dancing) and strength training.
• Not smoking.
• Keeping drinking to a minimum. Men should have no more than two standard drinks in a single day; for women, it’s just one.
• Getting sufficient sleep — at least seven hours a night.
• Maintaining a healthy weight.

“Diet and exercise are medicine,” Colon-Emeric says. “It’s really critical to pay attention to them in midlife.”