Tips to Get Back on a School Routine

 AREFA CASSOBHOY, MD, MPH:

All families need to relax the rules sometimes and maybe let regular routines slide. But getting back into a routine is important for your child's well-being.

Kids actually thrive when they have a regular routine. It helps them predict what's going to happen in a world where they don't have a lot of say. And it also helps them organize their time, so they know what activity is appropriate for certain periods of the day.

So how do you get your child on a routine? First, decide what's important. Getting ready for school, bath time, and dinner are all critical parts of your child's day. Set aside a realistic amount of time for those tasks. Then make room for downtime like play, reading, or relaxing.

Most kids will do better if you alert them to a change in activity ahead of time. Give them a heads up when playtime is over, or bedtime is coming up. You can set timers that the kids can watch and hear.

Most important, be consistent. If your routine regularly falls apart, it creates chaos. And lax routines can even cause anxiety in children. So even if they beg to stay up a little longer, stick with the program. Sure, it's OK to be flexible sometimes. But what you want is for your routines to eventually become old habit. 

Things That Raise Your Chances of Dementia

 Age

Alzheimer’s disease is the most common form of dementia. About a third of people 85 and older show signs of the disease. The genes you get from your parents play a part at this age, but so do things like diet, exercise, your social life, and other illnesses. Dementia isn't a normal part of getting older.

Heart Disease

It could lead to a heart attack or stroke, which makes dementia more likely. Heart disease is usually caused by plaque buildup in arteries around your heart (atherosclerosis). That can slow blood flow to your brain and put you at risk for stroke, making it harder to think well or remember things. And many things that cause heart disease -- tobacco use, diabetes, high blood pressure, and high cholesterol -- also can lead to dementia.

Air Pollution

An English study found older adults who lived in areas with the highest yearly concentration of air pollution were 1.4 times more likely to get dementia than people who lived in places with cleaner air. Nitrogen dioxide (NO2) and particulate matter (micro-particles in the air you might not see but can inhale) caused the most harm.

Diabetes

Doctors aren’t sure exactly why people with diabetes get dementia more often. But they do know that people with diabetes are more likely to have damaged blood vessels. This can slow or block blood flow to the brain and damage areas of the brain, leading to what’s called vascular dementia. Some people may be able to slow brain decline if they keep diabetes under control with medicine, exercise, and a healthy diet.

Poor Sense of Smell

Older people who have trouble identifying odors are more than twice as likely to have dementia as those with a sharp sense of smell. Almost half of people in an American study who’d been diagnosed with dementia had had olfactory dysfunction 5 years before. A simple smell test can flag a need for early treatment.

High Cholesterol

High levels, especially in middle age, are linked to obesity, high blood pressure, and diabetes. All of these raise your risk of dementia, but it’s not yet clear if the cholesterol by itself adds to the problem. Some research shows that high cholesterol in midlife could raise your chances of Alzheimer’s disease later in life, but the exact link isn’t clear.

Herpes

vHerpes simplex virus 1 (HSV1), or oral herpes, usually appears as blisters or sores on or around your mouth. But the virus can also get into and infect your brain. A recent study linked HSV1 with a decline in some mental functions, but not to dementia. However, lab studies on a realistic brain model showed HSV1 triggered major Alzheimer’s signs, including swelling and clumps of protein in the brain tissue.

Depression

If you have depression, or have had it in the past, you may be more likely to get dementia. Scientists aren’t yet sure that it’s a cause. It may simply be an early symptom or a sign of other causes like Parkinson’s disease or Huntington’s disease. Talk to your doctor or a therapist if you feel down for more than 2 weeks, and right away if you think of harming yourself. Therapy and medication can help with depression. 

Eating Patterns

Super-starchy and processed foods never make the “healthy” list. But did you know eating the two together can up your chances of having dementia? French researchers found people who developed dementia often paired processed meats – i.e. ham, pepperoni, and deli meats – with high carbs like potatoes, alcohol, and baked sweets. Meanwhile, people who stayed healthy ate their share of meat – but enjoyed it with fruits and veggies.

Head Injury

A single, mild traumatic brain injury may not make you more likely to get dementia later in life. But more severe or repeated hits or falls could double or quadruple your chances, even years after the first injury. Get to the hospital if you’ve hit your head and you pass out or have blurry vision, or feel dizzy, confused, nauseated, or become sensitive to light.

Loneliness

Feeling lonely over time can increase your chances of having dementia, even when your overall risk of getting the disease – such as with genetics or age – is low, a 10-year study found. People under age 80 who reported feeling alone were twice as likely to have dementia as those who didn’t feel that way. Time is key, though. People who recovered from their loneliness didn’t have the same risk.

Obesity

If you have a lot of extra weight in middle age, you may be more likely to get dementia later in life. Extra pounds raise your risk for heart disease and diabetes, which are also linked to dementia. You can check your BMI (body mass index) online to see if it’s in the “obese” range. Your doctor can help you set a weight loss goal that’s right for you. A healthy diet and regular exercise could help you turn things around.

Genes

Dementia doesn’t have to run in your family for you to get it, but genes make a difference. A parent or sibling with Alzheimer’s raises your odds. Genes seem to matter more in some types of dementia than others. But even risky genes don’t mean you’ll get dementia. If you’re thinking about genetic testing for Alzheimer’s, ask your doctor about the pros and cons -- and genetic counseling. Doctors don’t routinely recommend those tests.

Sleep

Many people have a bad night of sleep now and then. But if it happens often -- you wake up a lot or don’t sleep enough -- you could be more likely to get dementia, including Alzheimer’s disease, or make it worse. It may help to try and keep a healthy sleep routine: Avoid alcohol, caffeine, and electronics in evening, and set up a soothing bedtime ritual with regular bedtime hours.

Smoking

It seems to put you at risk of getting dementia, possibly because it’s bad for your blood vessels. And it definitely makes you more likely to have a stroke, which can and often does damage the brain and cause vascular dementia. That might lead to problems with thinking or remembering. Talk to your doctor or a mental health professional if you smoke and want support to quit.

The Truth about Carbs

 What Are Carbs?

They’re one of three types of food that give your body energy. The other two are proteins and fats. Together, they provide the fuel your body uses to build and repair itself. Carbs break down into glucose (sugar) that you can use right away.

Your Body’s Fuel

Your body runs on glucose. Your brain, in particular, needs it to work the way it should. Carbohydrates are an almost instant source of it. Your body can break down and use fat for some of the same needs, but not all of them. Plus, fat that’s used for fuel makes compounds called ketones that can raise the level of acid in your blood, and that can be unhealthy over the long term.

Workout Prep

Because carbs are a source of energy, they can keep you going strong while you exercise. Experts recommend fueling up 1 to 3 hours beforehand with a combination of carbs and protein, like oatmeal, Greek yogurt, peanut butter, or nuts and raisins.

Full of Nutrients

The best-quality carbs -- berries, vegetables, and whole grains -- are packed with vitamins, fiber, and antioxidants that are important for good health and well-being. Whole grains have fatty acids, magnesium, B vitamins, folate, and zinc. Fruit and starchy veggies have some of those, plus phytonutrients like flavonoids and carotenoids that help prevent disease. If you skip the carbs, you lose out on those nutrients, too.

Simple Carbs

Think of table sugar as simple carbs in pure form. They’re very small molecules, which makes them especially easy for your body to break down and use. That means they raise your glucose levels (blood sugar) really fast. Things that sweeten any number of candies, pastries, and desserts are loaded with these kinds of carbs.

Complex Carbs

String together a bunch of simple carbs, and you get these larger molecules. Your body has to break them down into simple carbohydrates and then into glucose before it can use them. This takes longer, which means your blood sugar goes up more slowly and they’re less likely to be changed into fat. These kinds of carbs include multigrain breads and pasta, beans, potatoes, and other vegetables.

Storage Tank

Before your body turns leftover glucose from carbs into fat, it stores what it can in your liver in the form of glycogen. This keeps your body going between meals. But your liver can only keep a day or so’s worth at a time.

If You Have Too Many

If you overdo the carbs, your blood sugar levels can get too high. This causes your body to make more insulin, which tells your cells to save the extra glucose as fat. That can be unhealthy if you’re already carrying a few extra pounds. It can lead to diabetes and other related health issues.

If You Don’t Have Enough

If there aren’t enough carbs in your diet, you could get constipated from lack of fiber and nutrients. Your body is also forced to use protein or fat for energy. Proteins are the building blocks of the body. If you use them as fuel, you may not have enough left to make more cells and keep them healthy.

The Right Amount

The number of carbs you need can depend on your gender, size, and how active you are -- and that can change as you get older. But as a general rule, about half your daily calories should come from carbs in fruits, vegetables, grains, beans, and dairy products. Just make sure to go with healthy, complex carbs and don’t overdo the simple ones.

Low-Carb Diets

In theory, fewer carbs mean less sugar. And “ketogenic” diets have been shown to help some people lose weight and control their blood sugar in the short term. But these diets include lots of protein, and your body may need to use stored calcium to digest it. Plus, digesting lots of protein can be hard on your kidneys over time. You also tend to eat more saturated fat to replace the carbs, and that can be unhealthy in the long term, too.

Diabetes and Carbs

If you have this disease, you need to watch your carbs carefully because your body has trouble keeping your blood sugar at a safe level. If you have too many, your body may not be able to bring your blood sugar down quickly enough. But if your blood sugar gets too low, a glass of juice or another simple carb might be just the thing to kick it back up again. If you have diabetes, talk with your doctor about the best way to manage carbs.

Where to Get Healthy Carbs

Look for unrefined whole grains like quinoa, rye, and barley instead of highly processed white bread and pastries. Whole unprocessed fruits and vegetables are better than juices. And it’s a good idea to pass on the high-carb potato foods, especially French fries, in favor of beans, chickpeas, and other legumes.

Supplement Smarts: The Best Ways to Take Different Vitamins

 Make Food Your Plan A

With hundreds of supplements available, it’s hard to believe that not every nutrient in whole foods has been captured in a capsule. That’s why eating a variety of healthy foods is the best way to meet your health needs. But if you’re low on a certain vitamin or mineral, or just want to cover all bases with a daily MVM (multivitamin/mineral), these tips will help you get the most from it.

Timing Your Multi

You can take your MVM any time you’d like. Your body absorbs some of its vitamins better with food, so you may want to take it with a meal or a snack. You’ll also avoid the upset stomach that you can get when you take it on an empty stomach. Not a breakfast person? Have it with lunch or even dinner.

When to Take Water-Soluble Vitamins

Water dissolves them, and your body doesn’t store them, so most must be taken every day. They include C and the B’s: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folic acid (B9), and cobalamin (B12). Take them with or without food, with one exception: You’ll absorb B12 better with a meal. If you also use vitamin C, put 2 hours between them. Vitamin C can keep your body from using B12.

When to Take Fat-Soluble Vitamins

Vitamins A, D, E, and K need to go with fat from a meal for your body to absorb and use them. But you don’t need a lot of fat -- or any saturated fat. The healthy plant-based kind you find in foods like avocado or nuts will do just fine. 

If You Take Iron Supplements

You absorb iron best on an empty stomach. Take it with water or, better yet, a citrus juice: Iron and vitamin C have a tag-team effect. If it makes you queasy, save it for right after a meal. But don’t mix it with calcium or high-calcium foods -- these interfere with iron. You won’t take in either one fully. Men and postmenopausal women should skip supplements with this mineral unless a doctor says otherwise. The average MVM has more than you need.

If You Take Mineral Supplements

Large doses of minerals can compete with each other to be absorbed. Don’t use calcium, zinc, or magnesium supplements at the same time. Also, these three minerals are easier on your tummy when you take them with food, so if your doctor recommends them, have them at different meals or snacks. Don’t take any individual mineral at the same time as an MVM or an antioxidant vitamin formula, like one with beta-carotene and lycopene. Also see: What is silicon dioxide and how is it used in supplements?

If You Take Vitamin A

Watch the amount of what’s called preformed vitamin A. If you’re pregnant, doses over 10,000 IU a day can cause birth defects. High levels of both A and the usually safe beta-carotene (a substance that the body coverts to vitamin A) may raise your chances of having lung cancer if you’re a smoker, and maybe even if you’re a former smoker.

Prenatal Vitamins and Morning Sickness

Extra folic acid and iron are very important for a healthy baby. They can be found in most prenatal vitamins. But some prenatal vitamins can make nausea worse, mostly because of the iron. If this happens to you, pair your prenatal vitamins with a light snack before you go to bed. Talk to your doctor about the best prenatal formula for you.

Supplements and Your Prescriptions

Even essential nutrients can interfere with many common medications. If you take a traditional blood thinner like warfarin, just the small amount of vitamin K in an MVM can cut its strength. Taking more than 1,000 mg of vitamin E per day can raise your risk for bleeding. And if you take thyroid medication, taking calcium, magnesium, or iron within 4 hours can cut its strength. Ask your doctor about how best to time it.

The Alphabet of Amounts

RDA (recommended daily allowance) is the daily amount of a nutrient you should get, based on sex and age. DV (daily value) is the percentage of a nutrient that a supplement or food serving adds to the average daily diet for all ages. UL (upper limit) is the most of a nutrient you should get in a day. Side effects from big doses range from tiredness or diarrhea to kidney stones or organ damage.

Know What’s Inside

There’s no one standard MVM formula. Some have more nutrients than recommended. Others may come up short on some RDAs. For instance, the amount of calcium you need to meet the RDA is too much to fit into a tablet that you could easily swallow. Scan the full ingredients list so you know exactly what’s in the supplement you’re considering. This will also help you know if you need to time when you take it.

Personalize Your Formula

Another way to get more of the nutrients you need is to shop for formulas geared to your age and sex. For example, many vitamins for seniors have more calcium and vitamins D and B12 than younger people need. As you get older, your body doesn’t do as good a job of absorbing B12. Women in particular often need extra calcium and vitamin D after menopause to protect bones. Men’s formulas leave out the iron.

Are Gummies Any Good?

Opinions about gummy vitamins are mixed. One study found that people who take vitamin D in gummy form get more from it than from a tablet. On the other hand, gummies can have a lot of sugar and calories. And because they taste like candy, it’s easy to go overboard and eat too many. They may even cause cavities. Also, not all brands contain all essential vitamins and minerals. Some may not even contain the amounts listed on the label.

Look for Quality Checks

Since the FDA doesn’t regulate supplements, look for brands that have been “verified” by one of the three companies that test supplements in the U.S.: Pharmacopeia, Consumer Lab, or NSF International. These testing organizations verify that what’s on the label is in the bottle in the right amounts.

Keep a Supplement Diary

If you keep a log, it can help you time out different supplements and keep track of how much you take every day. The National Institute of Health’s Office of Dietary Supplements has a form called "My Dietary Supplement and Medicine Record" that you can print out and fill in. Bring it with you, along with your medication list, when you go to doctor visits.

Psoriatic Arthritis Symptoms & Signs

 Medically Reviewed by Shruthi N, MD on June 24, 2024Written by Lori M. King, PhD

What Is Psoriatic Arthritis?

Psoriatic (pronounced saw-ree-a-tuhk) arthritis is a chronic inflammatory arthritis. Anyone can get psoriatic arthritis, but about 33%-50% of people who get it either have psoriasis themselves or have a first-degree family member (mother, father, or siblings) with psoriasis.

Keep a watch out for joint, nail, and eye symptoms if you or a close family member has psoriasis.

Both psoriasis and psoriatic arthritis are autoimmune conditions. This means that your immune system mistakenly attacks your own body tissues. Psoriatic arthritis leads to signs and symptoms in your skin, joints, and nails, as well as fatigue. Read on to learn more.

Musculoskeletal Psoriatic Arthritis Symptoms

Psoriatic arthritis can affect any joint in your body, whether that's your large joints, such as your knees and shoulders, or your small joints such as your fingers, toes, back, and pelvis. The most common musculoskeletal psoriatic arthritis symptoms include:

Joint pain and stiffness

Discoloration or redness near your affected joints

Pain or tenderness where your tendons and ligaments attach to your bones, especially at the back of your heel (Achilles tendinitis) or in the sole of your foot (plantar fasciitis)

Swelling in your fingers and toes, which your doctor may call dactylitis or "sausage fingers"

Traditionally, psoriatic arthritis has been classified as one of five types based on which of your joints are affected and on which side of your body you have symptoms. The five types include:

Oligoarticular arthritis. This type usually affects two to four joints at the same time on both sides of your body. For instance, you may have swelling and pain in one of your knees and one of your elbows. This is the most common type of psoriatic arthritis.

Polyarticular arthritis. This type looks a lot like rheumatoid arthritis, and it's the second most common type. It usually affects more than five joints at the same time, most often the same joints on both sides of your body. For example, it may affect both of your knees and both of your elbows.

Distal arthritis. This type usually affects the joints near the end of your fingers and toes, though it can affect other joints as well. With this type, you will usually also have symptoms in your fingernails and toenails. For instance, your nails might look discolored, flaky, or pitted.

Spondylarthritis. This type usually affects the joints between the vertebras in your back, as well as the joints in your hips and shoulders.

 Arthritis mutilans. This is the rarest and most serious type. It causes inflammation that is so severe, it can cause bone loss (also called osteolysis). Bone loss leads to joint deformities, especially in your hands and feet.

Symptoms of Psoriatic Arthritis in the Skin

You will usually have skin symptoms of psoriasis before joint symptoms, but they may start at the same time. Or you may get arthritis before skin symptoms. Your skin symptoms can be mild or severe, and the severity of your rashes won't necessarily match the severity of your joint symptoms.

The skin symptoms include:

Rash plaques. Plaques are rashes that look raised, thickened, and discolored (silver or gray), and they most often form on your knees, elbows, scalp, and lower back. The rash is also scaly and will flake off easily. Your skin may bleed when the scales flake off.

Itchy skin

Painful skin

Symptoms of Psoriatic Arthritis in the Nails

About 80%-90% of people with psoriatic arthritis will get nail symptoms. You may get symptoms in your fingernails and toenails that can be uncomfortable or painful. The severity of your nail symptoms often matches the severity of your skin and joint disease.

These symptoms include:

Discoloration of your nail beds (the skin under your nails). The discoloration is often yellow, pink, red, or brown. You may also get splinter hemorrhages, which are thin, red to reddish-brown lines of blood under your nails. They run in the direction of nail growth.

Pitting or denting. Your nails may have pits that are the size of a pin tip or dents that are as big as the tip of a crayon. You may have only a couple of pits or many across your nail.

Nail structure changes. This can include:

Horizontal grooves across the surface (Beau's lines)

Thinning of the nail that leads to crumbling

Separation of your nail from your nail bed (onycholysis)

Signs of Psoriatic Arthritis in the Eyes

About 7% of people with psoriatic arthritis will also develop uveitis (pronounced you-vee-eye-tis). Uveitis causes inflammation in the middle layer of your eye. Symptoms of uveitis include:

Eye redness or irritation

Eye pain

Blurred vision

Light sensitivity (photophobia)

Swollen conjunctiva, which is the thin, clear membrane that covers the inside of your eyelid and the white of your eye

Managing Psoriatic Arthritis at Work

Other Common Symptoms of Psoriatic Arthritis

Some people with psoriatic arthritis also:

Feel very tired or low energy (fatigue)

Have inflammatory bowel disease (IBD), which causes inflammation in your digestive system

What Are the Early Signs of Psoriatic Arthritis?

Psoriatic arthritis has a variety of symptoms, and they vary from person to person. So, there's no one sign or symptom that will point to psoriatic arthritis.

If you have psoriasis or family members with psoriasis, watch out for the signs and symptoms of psoriatic arthritis. You're looking for a pattern, not just one or two signs or symptoms.

You may be more likely to have a flare-up of symptoms after a triggering event, such as:

Stress

Infections or injuries

Smoking or exposure to tobacco smoke

Cold weather

Drinking a lot of alcohol

What is the difference between signs of rheumatoid arthritis and psoriatic arthritis?

Both rheumatoid and psoriatic arthritis are autoimmune conditions that cause chronic inflammation of your joints. They have very similar joint symptoms. However, with rheumatoid arthritis, you will usually have symptoms in the same joint on both sides of your body. For instance, you might have symptoms in both wrists at the same time. With psoriatic arthritis, you will usually have symptoms in different joints on both sides of your body. For instance, you might have symptoms in your left wrist and your right knee around the same time. Also, if you have psoriatic arthritis, you will most likely have skin and nail symptoms in addition to joint symptoms.

Possible Complications of Psoriatic Arthritis

Having psoriatic arthritis can make you more likely to develop other conditions over time. Some of the most common conditions you may be at increased risk for include:

High blood pressure

High cholesterol

Obesity

Diabetes

Depression

Anemia

Muscle weakness

Many of these complications may be the result of the ongoing effects of inflammation. In addition, painful joints and fatigue can make it challenging to be physically active, which also increases your chances of developing obesity, diabetes, high cholesterol, and high blood pressure. Ask your doctor about activities you can do that won't put as much strain on your joints. They may recommend walking, aqua therapy, or yoga as good ways to stay active without stressing your joints.

When Should I See a Doctor?

Go see your doctor if you notice rashes or other skin symptoms or if you have joint pain.

Also, talk to your doctor if you have psoriatic arthritis and you have symptoms that are new, changing, coming on more frequently, or becoming more severe.

Takeaways

Psoriatic arthritis is a long-term inflammatory arthritis. It causes symptoms such as pain, stiffness, redness, and swelling in your joints and where your tendons and ligaments attach to your bones. You may also have skin rashes, pitting and discoloration in your nails, and redness and swelling in your eyes. If you have skin rashes and joint symptoms, go see your doctor. Untreated psoriatic arthritis can make you more likely to have complications, such as diabetes or high blood pressure.

Psoriatic Arthritis Symptoms FAQs

Can lifestyle changes prevent psoriatic arthritis?

It's difficult to say if lifestyle changes can prevent psoriatic arthritis because researchers don't know exactly what causes it. However, making some lifestyle changes can improve your health overall and reduce general inflammation in your body. So, there's good reason to believe that a healthy lifestyle may help prevent all types of arthritis or make management easier if you develop it. Your doctor will likely recommend you:

Avoid tobacco products

Follow a healthy diet and exercise plan

Do low-impact exercise

Use equipment that protects your joints when doing any activity that could cause an injury

SOURCES:

Tiwari, T. Psoriatic Arthritis, StatPearls Publishing, 2024.

National Institute of Arthritis and Musculoskeletal and Skin Disorders: "Psoriatic Arthritis."

National Health Service: "Psoriatic arthritis."

Cleveland Clinic: "Psoriatic Arthritis," "Psoriasis," "Nail psoriasis," "Uveitis."

Mount Sinai: "Splinter hemorrhages."

National Psoriasis Foundation: "Eye Inflammation and Psoriatic Arthritis."

UCLA Health: "Early signs of psoriatic arthritis."

RMD Open: "Distinguishing rheumatoid arthritis from psoriatic arthritis."

Arthritis Foundation: "Psoriatic Arthritis," "Psoriasis and Psoriatic Arthritis Linked to Increased Gout Risk."

Current Rheumatology Reports: "Arthritis mutilans."

The Journal of Rheumatology: "Acute Presentation of Arthritis Mutilans."

The Psoriasis and Psoriatic Arthritis Alliance: “Why do I feel so tired?"

Older Adults Redefine Love to Combat Loneliness

 Written by Donavyn Coffey

Aug. 13, 2024 -- Eight years ago, Lori, a 64-year-old retiree living in Maine, was beside herself with grief as her daughter moved away. Afraid of the impending loneliness, she called the one person she knew she could live alongside: her ex.

In her 17 years as a divorcee, Lori – who asked that her last name not be used -- occasionally browsed an online dating site and has been in two long-term relationships. But after the last breakup, “I realized I didn’t mind doing life by myself, doing what I wanted to do when I wanted to do it,” she said. Soon after, she invited her ex to move back in.

For almost a decade the two have shared costs, a garden out back, and friendship but no romance. The arrangement may seem unusual, but Lori says it staves off loneliness and still affords her the independence she’s come to love. Not to mention it's easier on a fixed income. She’s still open to dating if it happens, but looking for love is no longer a priority. And she’s not alone.

According to Pew Research, 39% of women and 25% of men 65 and older aren’t married, living with a partner, or in a committed relationship. They’re the largest group of older adult singles in history. And most of them aren’t dating or looking. Only 16% of singles 65 and older are looking for dates or a relationship.

Don’t Let Loneliness Harm Your Health

Medically Reviewed by Poonam Sachdev on August 30, 2023

The health impacts of loneliness have only recently gotten the attention they deserve. In 2023, the surgeon general declared an epidemic of loneliness and isolation, citing serious health consequences like increased risk of dementia, heart disease, and certain cancers.

One meta-analysis even found loneliness was linked to a 14% increase in the risk of early death. Social isolation increased the risk to 26%. Older single adults are particularly vulnerable to isolation and loneliness, especially as they age and lose mobility. Harris said there could be long-term negative outcomes from not re-partnering.

Spouses have traditionally been the primary companions and caregivers of older age, but current older adults say they aren’t looking to date or remarry. Older adults are at a stage when many can afford to design the life they want — and romantic partnership doesn’t meet the needs of every person, experts told WebMD. Dating options, shifting priorities, finances, and family all factor into their decision. But if they continue to age solo, who will see them through an epidemic of loneliness and help them age in place?

A Numbers Problem

In the 60-plus dating pool, the most straightforward deterrent to dating is the gender ratio: Women have a numerical disadvantage. Because women tend to outlive men, single females aged 60 to 64 outnumber men 1.3 to 1, based on 2022 US Census data. By 75, the ratio is skewed more dramatically: 2.8 women for every man.

“For every single man there's 21 women lined up to date him,” said Rene Roy, a 61-year-old from southern Kentucky, about her church. Though she’s never been married, Roy remains open to dating and marriage. However, meeting new men in a small town is a challenge — and it’s only compounded by the comparatively outsized number of single women, she said.

Some women may express less interest in dating or re-partnering simply because they experience a lack of good options, said Lauren Harris, PhD, assistant professor at the University of New Hampshire, who studies romantic relationships and aging.

Newfound freedom

Most single seniors; however, appear to be content with their relationship status. Older adults, in general, tend to have more self-confidence and are more at ease being single. And in the Pew report, the most common reason respondents gave for not dating was enjoying being single and other priorities.

It’s not uncommon for either gender to decide they’re “not interested in negotiating and collaborating” with a partner any longer, said Pebble Kranz, MD, a sexual medicine specialist and medical director of the Rochester Center for Sexual Wellness in upstate New York. Older adults may prefer any number of relationships or pursuits; grandchildren, hobbies, and friends can all take priority over romance.

This is especially true for women. By the time they are single and in their 60s, “many women are done,” said Sharon Sassler, PhD, a sociologist and family demographer at Cornell University in Ithaca, NY. Having spent much of their life caregiving, either for children, parents, or a past spouse, many women aren’t looking to partner again.

Harris said that her female survey respondents often say things like, “I finally can do whatever I want, and I want to keep that” or “I had a marriage. My husband was great. I just don’t want that again.”

And they do well relationally without a partner. Women are considered kinkeepers, adept at networking and maintaining social bonds, Harris said. They often don’t feel the need for a partner because they already lead rich social lives filling their time with family, volunteer work, church, pickleball leagues, tennis clubs, and book clubs, she said.

In contrast, single older men are more interested in significant commitment from a partner. Men tend to be more emotionally dependent on their partner, and one study found that widowers with low or average social support remarry sooner. Romantic relationships may be more essential for them to stave off loneliness.

Leading up to a recent knee replacement, Roy, in Kentucky, worried over her recovery: Who would help her? Who would she talk to in the weeks home alone? But over the course of her recovery, her friends from church and volunteering stocked her fridge, drove her to appointments, and made regular visits. “God provided me a little family of my friends,” she said.

Keeping It Casual

Whatever their relational needs, seniors often find unique ways — that don’t always fit into neat categories of single, looking, or partnered — to meet people.

Take Lori’s living situation with her ex-husband. Or Tom in Aiken, SC. In 14 years of singleness, he’s been in three dating relationships that lasted multiple years. All were on-again-off-again and not quite exclusive, but they were good companions and travel partners at the time, he said.

While Tom – who also asked that his last name not be used -- said he’s not against remarriage, it has some financial downsides — legally entangling his business and his children’s inheritance. “Financially ... it makes more sense for me to stay single,” he said.

Many seniors agree, avoiding marriage and cohabitation because they don’t want to move, entangle finances, deplete their children’s inheritance, or be responsible for caregiving.

5 Ways for Seniors to Get Fit

From hikes to hula hoops, there are several ways to stay in shape through the years.

At this stage of life, there’s far less emphasis on looking for someone to complete you or to build your life with, Harris said. Dating for older adults is more casual — less about marriage and cohabitation and more about “parallel companionship,” she said.

 “They want the love, companionship, and sexual relationship without the hassle of entering a legal union,” said Deborah Carr, PhD, a sociologist who studies later life at Boston University.

Meeting New People Online and Off

While many older people have reasons for not dating, many are also still open to love. But finding it may take some strategy.

“Whether [you are] 25 or 65, there might be a gap in what you want in your romantic life and what you have,” Carr said. Older adults, of any gender, may want to date but not be a part of activities or comfortable with the technology that allows them to meet new people.

Social circles can reinforce the seeming lack of options because they can be so gendered. Women tend to be very social, but common activities like volunteer work, church, and book clubs are largely female. Men may spend more time with family, golf buddies, or neighbors.

In either case, meeting potential dates often requires some strategy and willingness to deviate from your social circle, Sassler said. She studies how couples meet and said women, for instance, will have more luck meeting single men doing active activities like bird watching or volunteering for the Sierra Club. “You have to stay active and think hard about where the sex ratio is more balanced,” she said.

For those who feel they lack in-person options, online dating continues to grow. The number of single seniors who have used online dating increased from 3% in 2016 to 13% in 2019, according to the Pew Research Center.

Older adults can also be targeted on these apps. A Pew survey reported that almost half of online daters over 50 believed they had encountered someone trying to scam them. While that’s not a reason to avoid online dating, Carr recommends looping in a child or similar support if you do decide to try the online route.

They don’t need to vet every person you swipe right on, she said. But before you meet or share personal information, share the profile and conversation with a second set of eyes and ears.

“One of the beauties of old age is you gets to do whatever the heck you want. You have earned it,” Kranz said. “You have earned being single. You have earned an exploring partnership. And people should embrace whatever they want to do with this very important part of life.”

SOURCES:

 Lauren Harris, PhD, assistant professor, University of New Hampshire.

Sharon Sassler, PhD, sociologist and family demographer, Cornell University, Ithaca, NY.

Tom, Aiken, SC.

Deborah Carr, PhD, sociologist, Boston University.

Pebble Kranz, MD, sexual medicine specialist and medical director, Rochester Center for Sexual Wellness, New York.

Pew Research Center: "Dating at 50 and up: Older Americans’ experiences with online dating," "1. Americans’ personal experiences with online dating," "15% of American Adults Have Used Online Dating Sites or Mobile Dating Apps," "For Valentine’s Day, 5 facts about single Americans."

Journal of Marriage and Family: "The Desire to Date and Remarry Among Older Widows and Widowers," "Kinkeeping in the Familial Division of Labor."

mind.org.uk: "Men twice as likely as women to have no one to rely on for emotional support."

Psychology and Aging: "Satisfying singlehood as a function of age and cohort: Satisfaction with being single increases with age after midlife."

Psychological Bulletin: "Development of self-esteem from age 4 to 94 years: A meta-analysis of longitudinal studies."

U.S. Census Bureau: "B12002 | Sex by Marital Status by Age for the Population 15 Years and Over."

Nature Human Behavior: "A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality."

National Academies: "Social Isolation and Loneliness in Older Adults."

Is It Aging or Alzheimer's?

 Is Your Memory Slipping?

We all forget things sometimes, especially when life gets busy. You may start to notice this happening more often as you get older. Mild memory loss can be a normal part of aging. It doesn't necessarily mean you're going to have dementia. Only 1% of people over age 65 with normal age-related memory issues will get dementia each year.

When Forgetfulness Is a Problem

If memory loss makes it hard for you to handle your daily tasks, that's a sign you shouldn't ignore. Are you forgetting things you only just heard? Asking the same question over and over again? Relying on lots of paper or electronic reminders just to get through the day? Talk to your doctor if you or your family notices that happening to you.

Hard to Plan or Solve Problems?

Everybody makes a mistake sometimes. Maybe you made an error in the checkbook last month or paid the wrong amount on a bill. That's normal stuff we all do. But if you are really struggling to do things like follow directions in a familiar recipe or keep track of bills the way you used to do, it could be a warning sign of memory problems.

Struggle with Everyday Tasks

Having trouble using that TV remote? Forgot how to set the microwave? If you need a little help now and then with those kinds of things, it's likely nothing to worry about. But if you have problems doing regular activities you're used to doing, like driving to places you always go, playing favorite games, or finding your way at the grocery store, it may be a sign of a more serious memory issue.

Where Did I Park?

We've all had it happen. You come out of the store and think, "Now, where'd I leave my car?" It's normal to forget where you parked now and again. If it happens regularly, though, check with your doctor. It could be a warning sign of dementia.

Can't Find Your Keys

Most of the time when you forget where you've left something, like your keys or your glasses, you should be able to think back, retrace your steps, and find whatever it is. If you notice you're losing things all the time and you can't go back and spot them, which are a common sign of a bigger memory problem.

Losing Track of Time

Most of us have woken up and thought to ourselves, "What day is it?" It won't take you too long to figure it out. But if you are often losing track of dates, seasons, or the passage of time, that's another sign of real memory trouble.

How Did I Get Here?

If you walk into a room and can't remember what you were doing, that's not cause for concern. It happens to all of us. But people with Alzheimer's disease sometimes forget where they are. Or they find themselves somewhere and don't remember how they got there. If that's a problem you have, it's a good idea to get help.

What's the Word for It?

It's normal to have trouble finding the right word sometimes. Or you might use a word the wrong way. Not to worry. But people with Alzheimer's disease often start to have real trouble talking or writing. They might find it hard to recall the right term for familiar objects or the name of somebody they know well. If you're struggling with names, words, or what to say next, it may be a sign of more serious memory loss.

Withdraw From Friends and Family

Are you avoiding friends, family, or co-workers? Is it hard to carry on or follow a conversation? When memory problems become more severe, it's common for people to lose interest in hobbies, social events, or other activities they used to like doing. If that sounds like you, it's time to talk to someone about it.

Take a Memory Test

If you aren't sure if what you're going through is just regular aging, a doctor can help you figure it out. They'll know if the memory loss you have falls within the normal range or not. Your doctor will ask you questions and may ask you to take a series of tests. They may also check you for other problems that can look like dementia, such as medication side effects or depression.

Is There Anything I Can Do?

If your memory is OK but you're still worried, there may be something you can do about it. People who spend time reading, solving puzzles, or otherwise staying engaged are less likely to get Alzheimer's. It's possible that these activities can help you to keep your mind sharp. It's also a good idea to lower your stress, eat right, and exercise.