Guide

In your 50s

The 50s see cancer-screening cadence intensify, menopause for many women, and the consequences of earlier lifestyle and lipid management become visible. Acting now still substantially shifts the next 30 years.

Top priorities

1. Repeat CAC if previously zero. Many adults convert from CAC=0 to measurable CAC during the 50s.
2. Push for tighter apoB / BP control if atherosclerotic burden is established. See statins, PCSK9 inhibitors, SPRINT.
3. Cancer screening on schedule: colonoscopy or FIT (if not done at 45), mammography (women), low-dose CT if significant smoking history, cervical screening, skin checks.
4. Bone density baseline: see osteoporosis and DEXA.
5. Cognitive baseline: consider MoCA for serial comparison.
6. Hearing screening: untreated hearing loss is the largest modifiable dementia risk factor. See hearing loss.
7. Maintain muscle massaggressively. Resistance training, adequate protein (1.6–1.8 g/kg/day for many adults this decade), creatine.

What to measure annually

• Full lipid panel including apoB.
• HbA1c and fasting insulin.
• hsCRP.
• Liver enzymes, eGFR (with cystatin C if accessible).
• Thyroid, B12, vitamin D.
• VO₂max trend.
• Grip strength.
• Bone density (DEXA every 2–3 years).

Reasonable conversations to start

• MHT/HRT if peri- or post-menopausal — the timing window is now.
• TRT only if symptomatic and biochemically confirmed.
• Aspirin: ASPREE result suggests routine low-dose aspirin is no longer primary-prevention default. Discuss individually.
• Off-label rapamycin — the conversation can reasonably be had with a knowledgeable clinician, but evidence remains pre-RCT-outcomes.