Elam, 91, has been retired for 23 years from her job at United Food and Commercial Workers Local 770. And she is thriving, says Elam’s physician, Sonja Rosen, MD, chief of Geriatric Medicine at Cedars-Sinai, because Elam is doing retirement the right way.

“Carrie’s doing many of the things we encourage our patients to do as they age— keeping herself physically healthy and having a full social calendar,” Rosen said.

Statistics from the U.S. Bureau of Labor Statistics show nearly 20% of today’s workforce are 65 or older, up from 10% in the mid-1980s. And many older adults stay in the workforce for health—not financial—reasons. One analysis suggests that retiring earlier is associated with higher mortality, finding an 11% reduction in risk of death for each additional year of work.

So how can today’s older adults slow down or leave their careers without losing their health?

“Retirement from work is not retirement from life,” said Zaldy Tan, MD, MPH, medical director of the Jona Goldrich Center for Alzheimer’s and Memory Disorders at Cedars-Sinai. “It’s not like there is a universal, specific age at which our bodies shut down or our brains slow down to a halt. That is not physiological. This idea of retirement is man-made.”

The key factor, Tan said, is not retirement itself—but what people do after they stop working. Retirees who remain socially and cognitively engaged often experience better physical health, slower biological aging and improved mental wellbeing than those who do not, Tan said.

Elam is a perfect example. Her days still have structure and purpose: volunteering on her church’s fundraising committee, walking in Fox Hills Park, attending the opera and sharing Sunday dinners with family.

“I like to get dressed, give back to my community and make sure I have a full day,” Elam said.

Rosen said that sense of routine and purpose can make a big difference in how people experience retirement.

How to Prepare for a Healthy Retirement  

For many, a job gives more than income—it provides routine, purpose and daily social interaction. When the job disappears, the transition can be challenging, particularly for people whose relationships and activities revolve around the workplace.

“Work is sometimes seen as negative,” Tan said. “But we shouldn’t look at work as evil and vacation or retirement as good. It’s really what you make of both situations.”

Retirement can even improve the health of some—especially those leaving physically demanding or high-stress careers. Rosen said that some of her retired patients find they have more time to focus on exercise, cook healthier meals, spend time outdoors or explore new interests.

But Tan said the transition works best when people prepare for it.

“People spend years preparing to enter the workforce, but retirement requires discipline, too,” he said. “If your friendships and routines are centered on work, you need to start building activities, social connections and interests outside the workplace before you retire so you don’t end up isolated.”

Rosen recommends that people who are considering retiring take stock of where they find meaning in their lives—whether that purpose comes primarily from work or from activities, hobbies and relationships outside the workplace.

“What matters most are a patient’s individual goals and preferences,” Rosen said. “It really depends on the individual and what they find most meaningful in their life.”

For those who do retire, Rosen said maintaining structure and healthy habits is essential. She recommends aiming for at least 150 minutes of cardio each week and strength training twice a week. She also advises retirees to build social activities into their routines, such as volunteering or scheduling regular get-togethers with friends, to stay socially connected.

Mental stimulation is another important piece. Work often provides daily intellectual challenges, and Rosen said retirees benefit from replacing that engagement with activities such as continuing education, mentoring or doing memory exercises.

Elam, for example, reads every day and keeps her mind active with small mental exercises. If she can’t remember the name of something, she runs through the alphabet until a letter triggers her memory.

When Retirement Isn’t the Right Fit

For Christine Maclin, retirement simply wasn’t a good match.

Maclin, now 79, originally retired from her job as a cook at age 69, planning to rest and enjoy her free time. But after six months, she realized she missed the learning and sense of purpose that work provided.

“I mean, how many movies can you go to? How many coffee shops can you go to?” Maclin said. “I love hanging out with my friends, but ultimately I felt like retirement was time wasted.”

She returned to the workforce through a staffing company, first working as a cook for the Magic Castle and the University of Southern California—and later as an associate on the sales floor at Nordstrom. In January 2025, she decided to try something new and took a 10-week course in professional caregiving.

“What Christine has done—finding work and continuing to learn—shows that some patients fare better when they work,” Tan, Maclin’s physician, said.

Now Maclin works twice a week as a personal caregiver—cooking for her client, socializing and helping with errands—while continuing to learn something new every day.

“I like having somewhere to go and having something to do,” Maclin said.

Keeping a Positive Mindset, Retired or Working

Elam and Maclin each attribute their good health to a resilient, positive mindset.

Maclin says occasionally forgetting things is a normal part of life and not something worth getting upset about. Instead of becoming frustrated, she focuses on solving the problem, as she recently did one morning when she couldn’t recall if she had taken her medication.

“Instead of getting angry because you forgot something, solve the problem,” Maclin said. “I decided that after I take my medication, I just turn the container upside down, so I know.”

Elam says she tries to approach the aging process with as much style and grace as possible and avoids worrying prematurely.

Retired or not, she believes the key to staying healthy is simple: “Find activities you enjoy, and always be grateful,” Elam said.

Read more from Stories and Insights: Why Exercise Is Important as You Age

The new, five-year grant to examine sex-based differences in multiple age-related diseases supports the Microvascular Aging Effects—Women’s Evaluation of Systemic Aging Tenacity in Heart, Brain and Frailty study, commonly called MAE-WEST HBF. The acronym is a nod to the late actor, who reportedly once said, “You’re never too old to become younger.”

MAE-WEST HBF is funded as a Specialized Center of Research Excellence (SCORE) on Sex Differences through the NIH Office of Research on Women’s Health. It builds on prior research from Cedars-Sinai’s Barbra Streisand Women’s Heart Center that showed small blood vessel disease, chronic inflammation and iron buildup in women are linked to impaired heart, brain and kidney function, and declining physical strength.

“Armed with this funding, we are eager to continue uncovering biological mechanisms behind sex-based differences in aging and heart health,” said C. Noel Bairey Merz, MD, the principal investigator of MAE-WEST HBF and director of the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute. “A better understanding of the causes of common age-related conditions in women could lead to more effective prevention and treatment strategies.”

For more than two decades, Bairey Merz and her team have made landmark discoveries in women’s heart health, particularly in coronary microvascular disease—a condition that occurs more often in women and results from damage to the heart’s smallest blood vessels. Symptoms of the condition, which can be subtle, were previously often dismissed, misdiagnosed or undertreated. But improved diagnostic tools and treatments resulting from Bairey Merz’s discoveries have contributed to significant reductions in cardiovascular deaths among women.

The new study brings together a multidisciplinary team of experts, including Pascal Sati, PhD, director of the Neuroimaging Program in the Department of Neurology at Cedars-Sinai. Collaborators at UCLA will oversee biostatistical analysis, while those at the University of Texas at Arlington will lead frailty research.

“We now have effective treatments for small vessel dysfunction in the heart,” Bairey Merz said. “If we can better understand its effects on the brain and musculoskeletal system, we may be able to find ways to prevent or slow multiple age-related diseases—including declines in cognition and mobility—in both women and men.”

Although women generally live longer than men do, women experience higher rates of chronic conditions and so spend more years in poor health. Ultimately, investigators hope the new study will pave the way for a future in which healthy aging for women includes earlier screenings, advanced technology, and preventive care that identifies risks and stops diseases before they begin.

“After more than 25 years of progress in women’s cardiovascular research, this grant helps advance whole-person care that supports heart health, brain function and physical strength,” said Eduardo Marbán, MD, PhD, executive director of the Smidt Heart Institute. “All three are equally essential to healthy aging.”

Cedars-Sinai Health Sciences University is advancing groundbreaking research and educating future leaders in medicine, biomedical sciences and allied health sciences. Learn more about the university.

Following a joyful holiday season spent with loved ones, many people start the new year feeling sluggish—often from indulging in rich food and drinks or falling out of their workout routines.

Time for a change, said Sara Espinoza, MD, medical director of the Cedars-Sinai Healthspan Clinic, which emphasizes maintaining a good quality of life while aging. 

“If people are feeling guilty because they overindulged, my advice is, don’t wallow in it,” Espinoza said. “Every day is a new day, and it’s never too late to turn over a new leaf—especially in the new year.”

Although many earnestly make healthy resolutions, a 2023 Forbes Health/OnePoll showed that the average resolution lasts less than four months. Espinoza sat down with the Cedars-Sinai Newsroom to explain how resolving to practice healthy habits today—such as regular exercise and healthy eating—can affect long-term health.   

For people who are not feeling their best after the holidays, what are some healthy resolutions they can make to start feeling better?

When people feel sluggish after the holidays, I usually start with recommending sleep. Sleep hygiene is critical for restoring energy, and one of the simplest steps is going to bed at the same time every night.

After sleep, consistent physical activity is one of the most effective ways to improve energy levels. If someone continues to feel fatigued despite improving sleep and exercise habits, that can be a signal of depression, and I recommend being screened.

What New Year's resolutions would you say have the biggest impact on longevity?

I almost always point to physical activity as having the greatest impact on long-term health.

I encourage people to aim for at least 150 minutes of cardiovascular exercise per week, along with resistance training two days a week. That resistance training does not have to be complicated and can include body-weight exercises.

If that amount of exercise feels out of reach, I don’t want people to get discouraged. Even starting with a resolution to walk more each day is beneficial, especially because there is evidence showing regular walking reduces the risk of heart disease and stroke.

My main message is any time working out is better than no time.

How do healthy daily habits support healthy aging and help prevent age-related diseases?

I talk frequently with patients about maintaining a healthy body weight because of its strong link to long-term health. Even modest weight loss—about 5% to 10% of body weight—can significantly reduce the risk of developing diabetes, sometimes by as much as 60%.

Research also shows that reducing calorie intake over several years can improve cardiovascular health, cholesterol levels and insulin sensitivity in young to middle-aged adults who are overweight or obese.

When discussing diet, I often reference Harvard’s Healthy Eating Plate. About half the plate should be fruits and vegetables, a quarter should be whole grains such as brown rice or whole-wheat bread, and the remaining quarter should be healthy protein sources like fish, poultry, beans or nuts.

That said, dietary changes do not need to be extreme to be effective. If the guideline feels too strict, I suggest small, realistic adjustments, such as sharing a side of fries or choosing a salad instead.

People do not need to overhaul their entire diet overnight. Even one vegetable-focused meal a day as a resolution is a step in the right direction. Moderation is key.

Why is it so hard to stick to New Year’s resolutions, and what evidence-based strategies help people follow through?

One of the biggest reasons people struggle to stick with New Year’s resolutions is a lack of accountability. I often recommend working out with a friend, joining a class or having someone regularly check in.

Research on fitness trackers and wearables is mixed, but for many people, tracking progress is motivating. Simply monitoring daily steps on a phone or pedometer can help maintain consistency or reinforce habits.

I also encourage SMART goal setting, meaning goals that are specific, measurable, achievable, relevant and time bound. Starting with small, incremental steps is far more sustainable than setting unrealistic resolutions.

What are some underrated or often overlooked habits that can improve long-term health and aging?

One habit that often is overlooked is oral health. Poor dental health has been linked to cardiovascular disease and dementia.

To support oral health, I recommend brushing at least twice a day, flossing daily and limiting sugary foods and drinks. Again, if that is too rigid, even brushing teeth twice a day is a great resolution.

Are there any extra resolutions that promote healthy aging?

Although general guidelines are a helpful starting point, my medical recommendations to support healthy aging resolutions for the greatest impact are tailored to an individual’s health status.

For older adults, for example, weight loss requires careful consideration because it can lead to loss of both fat and muscle. In those cases, weight loss combined with resistance training can help preserve muscle mass and maintain strength.

For patients with cardiovascular disease, I often recommend not smoking, limiting alcohol, taking prescribed blood pressure medications and following a low-sodium diet.

To make an appointment with the Healthspan Clinic, call 310-423-3870 and select option 1 and ask to schedule an appointment with Espinoza.

Read more from Cedars-Sinai Stories and Insights: How to Think About Your Biological Age

Investigators at the Los Angeles Pepper Center will focus on extending older adults’ healthspan—which means aging with reduced burden of chronic diseases and conditions that lead to loss of independence—by studying interventions that target the biological processes of aging. Investigators then will translate those findings into clinical care.

“This prestigious grant provides Cedars-Sinai the opportunity to expand its geroscience research within our institution, across Los Angeles, and beyond, with the long-term goal of offering evidence-based healthy aging guidance for older adults,” said Sara Espinoza, MD, director of the Cedars-Sinai Center for Translational Geroscience.

For the next five years, Espinoza will lead the Los Angeles Pepper Center in collaboration with colleagues at USC and UCLA who say the combined expertise and resources of the three prominent institutions is a strong advantage.

“This partnership allows us to accelerate breakthroughs that can directly improve quality of life for older adults,” said Pinchas Cohen, MD, dean of the USC Leonard Davis School of Gerontology and co-director of the new center.

The Centers for Disease Control and Prevention projects that nearly one-quarter of the U.S. population will be 65 or older by 2060. Researchers say this creates a critical need to address the onset of multiple chronic diseases linked to aging. By intervening in the aging process at the biological level, scientists aim to prevent, delay and treat multiple medical conditions simultaneously.

“This designation strengthens our commitment to addressing the health challenges of aging—not only for today’s older adults, but for future generations as well,” said Jonathan Wanagat, MD, PHD, a geriatrician at UCLA and co-director of the Pepper Center.

The Claude D. Pepper Older Americans Independence Center in Los Angeles has four aims: to further develop gerotherapeutics—drugs that target the underlying cellular aging processes—and increase the number of researchers, expand clinical trials, and share the latest findings in translational geroscience.

“The robust resources, network and infrastructure made possible by the NIH solidifies Los Angeles’ leading position in aging research and geriatric clinical care,” Espinoza said. 

Read more in Cedars-Sinai Discoveries Magazine: The Future of Aging Research

Healthcare professionals in the Healthspan Clinic concentrate on the prevention and treatment of age-related illnesses and disabilities like cognitive decline and impaired mobility. The clinic is open to patients 18 and older.

“Aging is the leading risk factor for developing multiple chronic conditions that diminish quality of life,” said Sara Espinoza, MD, medical director of the Cedars-Sinai Healthspan Clinic and a Gerontological Society of America fellow. “This unique clinic offers scientifically backed science with clinically proven treatment and lifestyle recommendations that can improve health and wellbeing—now—and as individuals age.”

While advancements in medicine like antibiotics, vaccines and childbirth care have increased the average U.S. lifespan, physician-scientists at Cedars-Sinai are more concerned with keeping patients healthy—not merely alive. The medical term is “healthspan,” and the clinic’s experts say their goal is to help adults stay healthy and independent as long as possible.

“To do so, it is important that our approach is guided by scientifically proven, evidence-based findings about the fundamental aging processes that are root-cause contributors to multiple disorders and diseases—in other words, the new field of geroscience,” said James Kirkland, MD, PhD, director of the Center for Advanced Gerotherapeutics at Cedars-Sinai.

Patients seeking care at Cedars-Sinai’s Healthspan Clinic participate in at least one in-person visit. Experts assess patients for physical and cognitive function, lifestyle factors such as diet and exercise, and overall health status.

Espinoza said these consultations are an opportunity to discuss healthy-aging goals and habits. Patients are provided guidance on lifestyle, such as diet, exercise and sleep quality. Patients in the Healthspan Clinic also can opt to participate in a biorepository that analyzes patients’ blood and other data to track biomarkers linked to the onset of diseases.

“This clinic is an opportunity to change the trajectory of a patient’s health before they have complex medical issues,” said Espinoza, also the director of the Center for Translational Geroscience at Cedars-Sinai, where investigators conduct clinical trials for medicines and lifestyle advances aimed at healthy aging.

Nicolas Musi, MD, director of Cedars-Sinai’s Diabetes and Aging Center and the Division of Endocrinology, Diabetes and Metabolism, and Kirkland are also part of the clinic and provide treatment recommendations for metabolism, endocrinology concerns, and questions regarding interventions that potentially affect fundamental aging processes.

Espinoza said Healthspan physicians can refer interested patients to geroscience clinical trials at Cedars-Sinai or through the Translational Geroscience Network—an international consortium studying the biology of aging to prevent, delay or treat age-related diseases.

The network comprises 90 clinical trials across the U.S. and northern Europe and is led by Kirkland. The National Institutes of Health recently renewed the Translational Geroscience Network grant, awarding nearly $3 million over the next four years.

“The NIH renewal allows the network to keep studying a range of conditions that accelerate aging, including long COVID, obesity and Alzheimer’s disease, to ultimately find new ways to help people age in better health,” Kirkland said.

As the Healthspan Clinic grows, Espinoza also plans to hire physical trainers and dietitians to help curate personalized diet and exercise plans for patients.

To make an appointment with the Healthspan Clinic, call 310-423-3870 and select option 1.

Read more from Discoveries: The Future of Aging Research

“It’s not just sniffles or cold-like symptoms. It can turn into pneumonia or an even more severe illness for older adults that can lead to hospitalization and, unfortunately, sometimes their demise,” said Leslie Ramirez, MD, a physician with Cedars-Sinai’s Senior Advantage program, which specializes in caring for medically complex Medicare Advantage patients 65 and older.

Because the body’s immune system weakens with age, Ramirez said, viruses like influenza can cause more serious illness in older adults. Once hospitalized, they’re at even higher risk for developing bedsores and skin infections from lack of movement. And unlike younger people whose condition rapidly improves once an illness passes, it can take weeks for older adults to regain their strength.

“If they’ve been in the hospital for a while, when they return home, they can struggle getting in and out of bed, getting to the bathroom or sitting down and standing up,” Ramirez said. “It complicates their care and increases the burden on the family members trying to help them.”

The Cedars-Sinai Newsroom talked with Ramirez about the most effective ways to help older adults avoid a hospital stay altogether.

What can cause an older adult with the flu to need hospital care?

The flu can trigger a huge inflammatory response in the lungs of older adults who may not be able to continue breathing on their own. They might need supplemental oxygen and fluids because we tend to eat and drink less when we’re ill. Dehydration can be very harmful in older patients, causing their blood pressure to drop, as well as respiratory distress.

Older adults also are more likely to have multiple chronic health issues—heart, lung and kidney conditions—and an influenza infection can make all of those worse.

If an older adult gets the flu, how can they avoid a severe illness?

They should contact their provider as soon as they experience flu-like symptoms—fever, chills, body aches, maybe a sore throat or diarrhea—or get tested for the flu at a nearby urgent care. With a confirmed diagnosis, patients might be eligible for Tamiflu, an antiviral treatment that can help shorten the length of illness and decrease severity. But the medication must be started within five days of symptom onset.

It's also important to rest and drink plenty of water. Chicken noodle soup or broth also can help with hydration. Acetaminophen can help reduce a fever, ibuprofen can ease body aches and over-the-counter cough suppressants can help ease a cough. But always check with a provider before taking a new drug to ensure it won’t interact with your current medications or chronic conditions.

Do you have any advice for caregivers or loved ones of older adults?

It’s important to identify flu symptoms early—a fever above 100.4 degrees, chills, fatigue, body aches, an itchy throat. If you notice that an older loved one with the flu is starting to become more lethargic, very weak or confused—they don’t know where they are or who they are, and they’re usually very aware of their surroundings—those are big flags that the severity of their illness is increasing. Take them to the emergency department or call their provider immediately.

If they start complaining that they haven’t gone to the restroom as much as they normally do, that could be a sign they’re not drinking enough, or their kidneys aren’t functioning well. If their cough worsens and they’re having difficulty breathing or they’re short of breath or they can’t walk to the bathroom—those are all red flags.

How can older adults avoid the flu?

Wash your hands, especially if you’re going to be eating or you’ve been in an environment that might not be clean. You might want to avoid crowded places like giant sporting events during flu season. I’m not advocating that people skip important life events like a wedding or gathering with family, but take precautions, such as masking or keeping your distance. Some people still choose not to shake hands.

And, of course, get the flu shot. The flu vaccine is available at local pharmacies and in our clinic at Cedars-Sinai. For those 65 and older, there is a high-dose flu shot because their immune system isn’t as reactive as it used to be, and they need a stronger dose to mount a successful immune response. Younger family members also should consider getting vaccinated to reduce their risk of contracting influenza and passing it on to their older relatives. But remember, it takes two weeks to become fully protected. Keep that in mind if you want to time your flu shot ahead of Thanksgiving, the holidays or major travel.

Read more on the Cedars-Sinai Blog: Care Coordination for the Sandwich Generation

The Centers for Medicare & Medicaid Services (CMS) recently selected the Cedars-Sinai CARES (Care Management/Alzheimer’s Expertise/Resources/Education/Social Support) Program for dementia patients and their caregivers as a Guiding an Improved Dementia Experience (GUIDE) Model site. The Cedars-Sinai CARES Program is among 14 established programs in California, and it is one of only two in Los Angeles selected by CMS for the established program track. 

Additionally, the medical center’s comprehensive outpatient Geriatrics Program for people 65 and older, along with its Bone Health Coaching Program, recently received Age-Friendly Health System Committed to Care Excellence recognition from The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States. Cedars-Sinai also is among just 30 hospitals nationwide recently selected to join the new Age-Friendly System-Wide Spread Collaborative, which aims to accelerate adoption of evidence-based, high-quality care for older adults across all the medical center’s sites and care settings.

“Cedars-Sinai cares for more patients over 80 than any other academic medical center in the country, so operating under an age-friendly healthcare model is critical to our continued ability to serve our growing community of older adults,” said Bryan Croft, the hospital’s executive vice president and chief operating officer. “In just over a decade, the U.S. will have more people over age 65 than children, for the first time in history. An aging population has unique care needs, and these recognitions further demonstrate that Cedars-Sinai is the premier institution to provide this level of outstanding care.”

Cedars-Sinai Medical Center first received the Age-Friendly Health System Committed to Care Excellence designation in 2020.

Age-Friendly Health Systems integrate the “4Ms” of care: what matters most to each patient, medication safety, mobility and mentation, or mental functioning.

“Integrating the ‘4Ms’ framework into models of care for older people is about providing optimal care and measures of safety while addressing what’s most important to each individual patient,” said Sonja Rosen, MD, chief of Geriatric Medicine. “You can’t assume that everyone’s goals and preferences are the same. At Cedars-Sinai, we strive to help people live as healthy and high-functioning as possible for as long as possible and at the same time, achieve their goals.”

Cedars-Sinai’s outpatient Geriatrics Program has geriatricians who treat patients throughout the community for geriatric syndromes and primary care needs. This includes conducting consultations for falls, osteoporosis, polypharmacy—which is taking five or more medications—dementia, social isolation, loneliness, and other topics of importance for many older adults.

The hospital’s outpatient Bone Health Coaching Program, part of the Geriatric Fracture Program in the Department of Orthopaedics, provides bone health assessments and counsels patients on how to reduce the risk of fragility fractures, often caused by poor bone quality associated with older age, reduced mobility and some medications. Poor bone quality is often a surprise to older adults – unless they are screened, they may not be aware. According to the U.S. Centers for Disease Control and Prevention, falls that cause fragility fractures are a primary cause of injury in people 65 and older and often lead to hospitalization, loss of independence and even death. 

“We aim to help preserve good quality of life and independence for our patients," said nurse practitioner Kathleen Breda, MSN, associate director of orthopaedic Clinical Programs. “We’re proud that our Bone Health Coaching Program has connected more than four times the national average of patients with bone health care and is an important element of our age-friendly model of care." 

The CARES Program at Cedars-Sinai provides comprehensive dementia care management for patients with Alzheimer’s disease and other dementias as well as support and training for their family caregivers.

With the CMS selection of the CARES Program as a GUIDE Model site, eligible Medicare patients in the program can access $2,500 annually for adult day care, in-home care and facility care expenses when they need additional help—for example, after a hospital stay or during times of decreased caregiver availability.

Patients in the moderate to late stages of dementia also will receive a CARES Program home visit to help evaluate their needs, ensure safety and promote sustainability of in-home care. Educational offerings for caregivers are also provided.

“The selection of our CARES Program as one of the CMS GUIDE established care sites is a testament to the high quality of care that we provide to patients with memory impairments and the support we provide to family caregivers of dementia patients,” said Zaldy Tan, MD, MPH, director of the CARES Program and the Jona Goldrich Center for Alzheimer’s and Memory Disorders. “We continue to see improved health outcomes in vulnerable patients who are enrolled in the program, and as a GUIDE Model site, we expect this to be further enhanced.”

Read more from the Cedars-Sinai Blog: Anxiety in the Golden Years: What You Should Know