We show you the health warning signs to look for as you hit the big 4-0 and beyond – plus how to prevent certain problems developing.

It’s only natural. Our bodies change as we get older. The majority of these changes are just part of the ageing process but some are more serious and need investigation. Dr Gerry McCabe, a GP in Hertfordshire, explains: ‘Women need to be aware that in order to maintain good health in middle age and beyond, they should be living a healthy lifestyle from their youth into adulthood – factors such as a low-sugar, low-fat diet, not smoking, moderate amounts of alcohol and, crucially, regular aerobic exercise are the key issues to address.’

Once you hit your 40s, the subtle changes of your previous decade start to become more obvious. Your periods will begin to change, your bone density declines because of falling oestrogen (hormone) levels, due to the menopause, and you may struggle to maintain a healthy weight because your metabolism slows down.

It may sound depressing but it needn’t be – you can take action to work against these signs of ageing.
It’s well worth putting in a little effort to reap the benefits of the decades in your life when you have more time to yourself, can still look great and feel fabulous, and realise that life really can begin at 40…

Dementia
This is a term used to describe various disorders associated with an ongoing decline of the brain and its abilities. In England, there are currently 570,000 people with dementia, and although it can occur at any age, it usually affects older people. The most common form of dementia is Alzheimer’s disease.

Symptoms: Alzheimer’s disease develops gradually. Early signs include often forgetting recent events, names and faces; regularly misplacing items; problems finding the right words and mood problems, such as apathy or irritability. As the disease develops, people may experience further decline in mental abilities and memory.

What can I do? There are changes you can make to your lifestyle that can help to reduce your risk of developing dementia in the future. Experts believe that stimulating activities, such as reading, playing board games, playing musical instruments and exercise, which keep your mind active, may reduce your risk. Losing weight can help, too, as becoming obese in mid-life increases your risk of dementia.

Medical help: There are no medical treatments that can reverse the effects of dementia. Drug treatment can, however, help manage some symptoms. Alternatively, stimulation of the brain is thought to help in slowing down the development of dementia. And there is evidence to support the efficacy of behaviour management, cognitive stimulation, multisensory stimulation and exercise.

Further help
● Alzheimer’s Society www.alzheimers.org.uk

Bladder incontinence
Also known as urinary or stress incontinence, this affects around three million people in the UK. It is thought to affect one in five women over the age of 40.

Symptoms: Classic signs are when a little urine leaks out, particularly when you laugh, cough or sneeze. The menopause often leaves many women vulnerable to the condition because the reduction in oestrogen, which helps keep tissues strong and elastic, means pelvic floor muscles, which usually support your bladder, become more lax.

What can I do? Daily pelvic floor exercises can help. Tighten the muscles around your back passage, vagina and front passage and lift up inside, as if you’re trying to stop yourself using the loo. Hold for as long as possible, rest briefly, then repeat as many times as you can.

Medical help: Bladder training techniques, where you empty your bladder at fixed intervals, can help,
or hormone replacement therapy (HRT) can improve symptoms. In severe cases, surgery may be required. Turn to pg 236 in the Choosing Your Consultant supplement for more on the techniques used.

Further help
● Visit www.nhsdirect.nhs.uk and type in ‘urinary incontinence’ in the search facility.

Arthritis and osteoporosis
Around eight million people in Britain suffer from osteoarthritis, the most common form of arthritis. Osteoporosis means porous bones, whereby bones become fragile and are prone to breaking.

Symptoms: Classic symptoms of osteoarthritis include stiff, painful and swollen joints. The pain may feel worse after exercise. If the condition is severe, your joints may look misshapen. With osteoporosis, you won’t know you have it until you break a bone, usually in the wrists or hips, or begin to lose height.

What can I do? Keep up your calcium intake and try ibuprofen and supplements, such as fish oils and glucosamine to relieve the pain. The best way to strengthen your bones is with weight-bearing exercise, such as brisk walking, aerobics or lifting weights. Or if your joint pain is bad, try swimming to keep joints mobile.

Medical help: Physiotherapy may help, or for very painful osteoarthritis, your GP may suggest steroid injections into the affected area. If you break a bone you should be given a DEXA scan (which measures bone density) to see if you need treatment for osteoporosis.

Further help
● Arthritis Care - www.arthritiscare.org.uk
● National Osteoporosis Society - www.nos.org.uk

Heart problems
Diseases of the heart and circulatory system (CVD) are the main cause of death in the UK and account for over 208,000 deaths per year, according to figures from The British Heart Foundation. CVD is now the main cause of death in women in Europe.

Symptoms: Heart disease usually presents itself with classic angina symptoms – tight, aching chest
pain when you exert yourself that disappears when you stop. Typical heart attack signs include crushing central chest pain that spreads to the shoulder, neck and arms, and nausea, but some women feel pain under the breast bone or indigestion-type pain.

What can I do?: Stopping smoking is the most important step you can take to reduce your risk of heart attack. Vital steps to prevent heart disease include maintaining a healthy weight – excess weight can cause high blood pressure, high cholesterol and diabetes, all of which can cause heart disease. Exercise and a balanced diet are essential. Try to avoid stress as this can cause heart disease symptoms, such as high blood pressure.

Medical help: If you have already suffered a heart attack or stroke, or have unstable angina, your GP may prescribe a low dose of aspirin to help prevent future problems. But aspirin is not suitable for everyone, so don’t take it without the advice of your GP. If you have high blood pressure, your GP may prescribe beta-blockers, which reduce the amount of work your heart has to do, particularly during exertion.

Further help
● British Heart Foundation - www.bhf.org.uk

Being overweight or obese
Obesity rates have tripled in the past 20 years and if current trends continue, at least one in three adults will be obese by 2012. To find out if you are a healthy weight, you need to calculate your body mass index (BMI). To work it out divide your weight in kilograms by your height in metres squared. Alternatively, you can use a BMI calculator on the internet. If your BMI measures 25-29.9 you are classed as overweight; 30-39.9 means you are obese; and over 40 indicates you are seriously overweight or morbidly obese.

Symptoms: If you’re overweight you’re more likely to suffer from high blood pressure and high cholesterol, especially if you’re less active and your diet is high in fat. Both of these are risk factors for heart disease.
Being overweight also increases your risk of developing diabetes.

If you’re urinating a lot and feeling constantly thirsty, visit your GP as these are symptoms of diabetes. Weight gain, along with symptoms such as fatigue, sensitivity to the cold and dry skin, could indicate an underactive thyroid. Symptoms often develop gradually, but if you’re concerned, see your GP.
 
What can I do? Regular exercise is vital to keep your metabolic rate up so you maintain lean muscle tissue rather than developing fat. Resistance training is ideal – so lift some weights, either free or fixed. Eat a healthy, balanced diet basing meals around low-GI carbohydrates, such as wholegrain bread, pasta and rice
– they’re filling but are low in fat.

Try dieting and exercising with a friend or join a slimming club – it’s easier if you have support.

Medical help: If your weight gain is down to a medical issue, such as an underactive thyroid, your GP will prescribe medication to help.

Further help
● The British Obesity Surgery Patient Association - www.bospa.org
● Visit www.nhs.uk then click the ‘lose weight’ heading in the ‘live well’ section, where you can also find a BMI calculator.

Dr Chris says…
‘Leaking urine is not normal and so you must go and see your GP. There are so many causes of incontinence and they are different in men and women but conditions are treatable. People are so embarrassed about going to see their doctor about it, but don’t be – they deal with this problem every day.’
 

Photographs: getty images