What Matters Before Something Is Wrong: Rethinking Prevention And Aging Well  

Most women don’t wake up one day and decide not to take health prevention seriously. What happens instead is quieter.

We’re surrounded by cultural messages that treat aging as something to resist – something to disguise, delay, or push out of view.

Over time, that resistance becomes invisible.

It doesn’t announce itself. It shows up as delay.

And without realizing it, many of us postpone the very steps that protect our strength, independence, and choices later on.

We rarely talk about how cultural myths shape health behavior and decision-making, especially for women.

When aging is framed as loss or decline, resistance becomes the default response. And when resistance is the default, prevention often feels optional, premature, or even unnecessary.

Psychologist Laura Carstensen has described how widely held negative beliefs about aging – sometimes called the “misery myth” – can quietly undermine motivation to invest in health and wellbeing over time.

Research supports this pattern. In a peer-reviewed study using two independent subsamples from the national U.S. Health and Retirement Study, researchers found that more negative self-perceptions of aging were associated with a higher likelihood of delaying needed health care and reporting barriers to seeking care.

Prevention isn’t about accepting decline. It’s about claiming our healthspan and staying engaged in the life we intend to keep living.

Four areas in particular deserve a closer look before a crisis forces the issue: falls, bone health and mobility, arteries and stroke risk, brain health, and cancer screening.

Staying on Your Feet: Falls, Bone Health, and Mobility

Why It Matters

According to major medical sources citing the National Osteoporosis Foundation, up to one in two women over 50 will break a bone due to osteoporosis, a risk equal to breast, ovarian, and uterine cancer combined.

After 60, one bad fall can change everything, from where you live to how independent you feel. Many falls are not random accidents; they’re the result of slow changes in balance, strength, vision, medications, and bone health that we often ignore until a crisis hits.

Prevention Highlights

Fall Risk Assessment

National fall-prevention guidance (including CDC and U.S Preventive Services Task Force recommendations) advises that anyone who has fallen, feels unsteady, or appears frail receive a structured falls risk assessment covering gait and balance, medication review, blood pressure when standing, vision, footwear, and home hazards. Exercise programs, especially those that build leg strength and balance, are recommended for adults 65+ to reduce fall risk.

Bone Density Testing

Bone density testing (DXA scan) remains the foundation for assessing bone density and fracture risk. Professional bone health organizations note that clinicians can add a Trabecular Bone Score (TBS), which analyzes bone microarchitecture to improve fracture-risk assessment, especially when results are borderline.

Bone Turnover Markers

Bone turnover markers such as CTX (C-terminal telopeptide) and P1NP (Procollagen Type 1 N-Terminal Propeptide) are blood tests sometimes used by specialists to monitor how bone treatment is responding, rather than waiting for the next DXA scan. They are not routinely used in all patients.

Tai Chi Benefits

Multiple clinical trials show that tai chi – slow, controlled movement practiced regularly – improves balance and reduces falls in older adults, including those at higher risk. Studies of adapted yoga and chair-based programs also show gains in stability and confidence in older adults.

Resistance and Strength Training

Recent meta-analyses (including large, pooled reviews of dozens of trials and thousands of participants) show that resistance and strength training programs significantly improve bone mineral density in postmenopausal women. Exercise is now considered a core component of bone-health prevention alongside adequate calcium and vitamin D.

Questions to Ask Your Doctor

“Can we do a quick fall-risk check today looking at my balance, leg strength, and medications, to see where I stand.”

“Given my age and history, when should I have my bone density checked, and how should we interpret the result for me?”

“Are there specific balance or strength programs, like tai chi or fall prevention classes, that you’ve seen make a difference for patients my age?”

Looking Under the Surface: Arteries and Stroke Risk

Why It Matters

Heart attacks and strokes often feel sudden, but the changes behind them usually develop slowly inside the arteries. Many strokes are linked to years of quiet shifts in blood pressure, cholesterol, heart rhythm, and vascular health that often go unnoticed. The American Heart Association notes that stroke is the fifth leading cause of death in the U.S., and the American Stroke Association reports that up to 80% of strokes are considered preventable.

Prevention Highlights

Arterial Stiffness Testing

Arterial stiffness testing is gaining attention as an early vascular risk signal. Large recent meta-analyses show it predicts cardiovascular and stroke risk independently of traditional factors and can help doctors make more precise risk estimates when standard tests leave uncertainty.

CAC Scoring

Coronary artery calcium (CAC) scoring uses CT imaging to detect actual plaque buildup in coronary arteries and is increasingly used to refine prevention decisions when standard risk scores are uncertain.

ApoB Testing

ApoB (apolipoprotein B) testing measures the number of atherogenic cholesterol particles and is now recognized by major cardiology groups as a more precise risk marker than LDL cholesterol alone in some patients.

Lipoprotein(a)

Lipoprotein(a) (Lp(a)) is a genetically driven cholesterol-related risk factor that is now widely recognized as a “risk-enhancing factor” in cardiovascular prevention guidelines.

Inflammation Markers

Inflammation markers such as hs-CRP (high-sensitivity C-reactive protein) are increasingly used in cardiology to identify residual inflammatory risk that may persist even when cholesterol is controlled.

Lifestyle Habits

Evidence-supported prevention patterns shown to reduce vascular risk include Mediterranean-style eating, regular movement, sleep quality, blood pressure control, and stress reduction.

Questions to Raise with Your Doctor

“Given my age, blood pressure, cholesterol, and family history, what is my personal heart and stroke risk, and what should I prioritize right now?

“With my particular risk factors, would there ever be a role for imaging my neck arteries – like a carotid ultrasound? Would it be useful at this time?

“As a woman in my 60s, are there any risks – like past pregnancy complications, migraine with aura, or autoimmune disease – that would change how we think about my stroke and heart risk?”

Staying You for Longer: Brain Health

Why It Matters

Brain health prevention may need to start earlier than many women realize. Research published in NeuroImage (2023) and related journals shows that women’s brains undergo measurable metabolic changes during the menopausal transition, likely reflecting shifts in hormone levels and energy use. These findings do not mean menopause causes Alzheimer’s disease, but they do suggest that midlife is a meaningful time to pay closer attention to factors known to support long-term brain health such as sleep, vascular health, physical activity, and cognitive engagement.

Prevention Highlights

• Blood tests measuring p-tau217, a tau protein marker associated with Alzheimer’s disease, are emerging as early detection tools, especially for people with symptoms.
• APOE4 genetic testing can indicate elevated Alzheimer’s risk, but gene status alone does not determine outcome and requires clinical context.
• Emerging research shows AI analysis of speech patterns can detect subtle language changes linked to early cognitive decline, though this remains primarily a research tool today.
• The Lancet Commission on dementia preventionidentifies poor sleep as a modifiable risk factor for cognitive decline; untreated hearing loss is one of the largest modifiable dementia risk factors, according to the Commission.
• Ongoing intellectual engagement and learning new skills help build cognitive reserve, which is associated with better brain resilience over time.

Questions for Your Doctor

“If I want to be proactive about brain health, which factors would you prioritize most for me right now – cardiovascular health, sleep quality, hearing protection?”

“How often should I have my hearing checked at my age, and at what point does hearing loss affect brain function?”

“Should I get a baseline cognitive assessment now, while I’m healthy?”

Detecting Earlier When It’s Treatable: Cancer Risk

Why it Matters

Cancer screening saves lives – but only if it’s used. According to the American Cancer Society and SEER (Surveillance, Epidemiology, and End Results) data, when breast cancer is detected at an early, localized stage, the five-year survival rate is about99%. When it is diagnosed after distant spread, survival drops to roughly 30%. Similar stage-at-diagnosis patterns are seen in colorectal, cervical, and skin cancers.

Prevention Highlights

Multi-Cancer Early Detection (MCED) Blood Tests

Multi-cancer early detection (MCED) blood tests are emerging tools designed to detect signals from multiple cancers in a single blood draw. Some have received FDA Breakthrough Device designation. They are promising but not yet standard screening, and experts recommend individualized discussion of benefits, limits, cost, and follow-up plans.

Specific Screenings

For women in their 60s and beyond, age- and risk-based screening, including mammography, colorectal screening (colonoscopy or stool-based tests), and lung screening for heavy smoking history, remains the evidence-based foundation for reducing cancer deaths.

AI-Assisted Mammography

Recent studies (2023–2024) show that AI-assisted mammography can improve cancer detection rates compared with radiologist review alone and is increasingly being integrated into clinical workflows.

Lifestyle Habits

American Cancer Society lifestyle prevention guidance emphasizes: maintain a healthy weight, limit alcohol, avoid smoking, stay physically active, and eat a fiber-rich diet.

Questions to Raise with Your Doctor

“Looking at my age, family history, and past results, which cancer screenings still offer meaningful benefits for me?”

“Are there any newer screening options you think might be appropriate for me, such as a multi‑cancer early detection blood test, or is staying consistent with the standard screening the better strategy?”

“For colon cancer screening, what are my options beyond colonoscopy?”

From Resistance to Readiness

Seeing aging as a stage that deserves investment opens the door to quieter, earlier conversations.

By making peace with aging, we’re free to prepare for it by staying in conversation with our own health.

Preparation is power.

The cultural script told us to resist aging.

The smarter script? Plan for it.

Every screening you schedule, every question you ask your doctor, every daily habit you strengthen… they’re investments in the life you’re still building.

And often, the first conversation isn’t with your doctor.

It’s with yourself.

Let’s Start a Conversation:

How much time and energy do you put into preventing decline and poor health as you age? What are your top priorities? Which screenings do you never miss?